Manager Revenue Cycle

Fairview Health Services•St. Paul, MN

7d•Remote

About The Position

Fairview is looking to hire a Revenue Cycle Manager to oversee our Billing and Claims Management department. This is a full-time, benefit-eligible position that offers flexibility to work in a virtual environment while maintaining close collaboration with leaders and teams across the organization. This is a unique leadership opportunity requiring strong knowledge of insurance claim billing rules and regulations, payer-specific billing guidance, and claims processing requirements. The Revenue Cycle Manager will oversee daily billing operations, including two supervisors and their respective teams, while monitoring department metrics, account activity, and overall billing performance. This role will partner closely with supervisors on unbilled account strategies, operational priorities, workflow development, process improvement, and collaboration across Revenue Cycle. The ideal candidate will have previous experience in insurance claims management and strong working knowledge of Epic Resolute Professional Billing (PB) and Hospital Billing (HB). Experience with claims submission, clearinghouses, payer processing guidelines, billing regulations, and payer-specific policies is essential. This position is focused on claims and billing operations rather than denial management. We are looking for a leader who can effectively manage competing priorities, troubleshoot complex billing and claims issues, and evaluate processes from a broader, system-wide perspective. The successful candidate will be a strong problem solver who can identify trends, understand downstream impacts, collaborate across Revenue Cycle workflows, and help develop strategies that improve billing performance and operational efficiency. This position is responsible for managing all aspects including overall general supervision, policy and procedure compliance, personnel training and development, performance measurement and appraisals. This position will manage team supervisors and/or leads and agents. The Manager is responsible for delivering the highest quality of service as efficiently as possible while meeting financial, performance and quality goals. The Manager must have the ability to work cross-functionally with other colleagues and work cooperatively with all levels of the business including both internal and external partners and vendors. The ideal candidate will be results oriented with a proven record of creating engaged employees and identifying ways to improve the patient experience.

Requirements

B.S./B.A. or Four (4) years of experience in an applicable field may substitute for a Bachelor’s degree.
3 years of people leadership experience in addition to the bachelors or 4 years of experience total of which 3 must be people leadership.
Strong knowledge of insurance claim billing rules and regulations, payer-specific billing guidance, and claims processing requirements.
Previous experience in insurance claims management.
Strong working knowledge of Epic Resolute Professional Billing (PB) and Hospital Billing (HB).
Experience with claims submission, clearinghouses, payer processing guidelines, billing regulations, and payer-specific policies is essential.
Ability to manage competing priorities, troubleshoot complex billing and claims issues, and evaluate processes from a broader, system-wide perspective.
Strong problem solver who can identify trends, understand downstream impacts, collaborate across Revenue Cycle workflows, and help develop strategies that improve billing performance and operational efficiency.
Overall general supervision, policy and procedure compliance, personnel training and development, performance measurement and appraisals.
Ability to work cross-functionally with other colleagues and work cooperatively with all levels of the business including both internal and external partners and vendors.
Proven record of creating engaged employees and identifying ways to improve the patient experience.
Must have a thorough working knowledge of third-party payers and insurance verification procedures and understand managed care and insurance contractual arrangements.
Must have proven experience in interviewing patients for the purpose of financial eligibility determination
Must be detail oriented, possess basic mathematical skills, and have sharp analytical skills to resolve financial issues as they relate to multiple groups including third party payers, physicians, patients, and the system.
Must be able to handle potentially stressful situations and multiple tasks simultaneously including instructing and counseling patients regarding Fairview Health Services payment policies and public assistance programs.
Must possess the ability to communicate effectively with patients, families, government entities, insurance companies, and Fairview Health Services staff.
Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served.
Communicates in a respective manner.
Ensures a safe, secure environment.
Fulfills all organizational requirements.
Completes all required learning relevant to the role.
Complies with and maintains knowledge of all relevant laws, regulation, policies, procedures and standards.

Nice To Haves

B.S./B.A.
Epic software experience
Previous healthcare leadership experience
Basic medical terminology knowledge

Responsibilities

Creates and implements department strategy related to the patient experience, team performance and quality.
Review and analyze business data to identify trends and provide recommendations to improve the patient experience
Develops and implements methods and procedures to meet and exceed productivity, efficiency, financial and quality goals.
Provides daily leadership and guidance, direction, and motivation to team.
Understands workload and ensures that team is meeting all performance expectations related to phone calls and work queues.
Ensures all productivity standards are met in a timely manner through measuring and monitoring. Analyzes weekly and monthly reports for performance measurement and efficiencies
Review policy and procedures and ensure all process and training documentation is up to date
Actively develop direct reports through coaching, feedback, and projects to ensure their success and to create a highly engaged, productive team while meeting all performance objectives
Conduct regular team meetings ensuring a sense of community among team and sharing performance and overall updates to keep the team informed
Responsible for overall team quality program ensuring that patient satisfaction is number one priority
Handles patient escalations to ensure complete patient satisfaction
Evaluates team and individual training needs and assists in developing plans for immediate and long-term performance improvements
Aids in the development and implementation of processes that improve efficiencies and quality within the department.
Interviews and hires staff as needed and approved by senior management
Conducts and reviews performance appraisals of direct reports, identifies performance problems, and initiates disciplinary actions. Evaluates subordinate’s performance by establishing objectives and measurements for supervisory and service personnel. Provides constructive feedback on a consistent basis
Works collaboratively with other departments sharing insights and creating process and procedure to improve the overall patient experience
Ensure that team meets all HIPAA requirements
Represent the department and/or organization to external departments and organizations
Ability to travel, one or more nights, for business when necessary. Ability to travel to individual hospitals for meetings, patient requests and employee oversight
Perform ongoing staffing analysis based on current business needs and make recommendations as appropriate
Assist in the review, analysis, and implementation of system work driver tools
Assist in the budgetary process
Serve as a financial counseling program expert and lead resource for financial counselors and charity care coordinator regarding all types of funding programs, to ensure that all Fairview Health Services patients are screened and qualified for assistance.
Responsible for providing lead support to Supervisors and Managers for Fairview Health Services hospitals and clinics
Acts as mentor and trainer for new and veteran staff
Must have a thorough working knowledge of third-party payers and insurance verification procedures and understand managed care and insurance contractual arrangements.
Must have proven experience in interviewing patients for the purpose of financial eligibility determination
Must be detail oriented, possess basic mathematical skills, and have sharp analytical skills to resolve financial issues as they relate to multiple groups including third party payers, physicians, patients, and the system.
Must be able to handle potentially stressful situations and multiple tasks simultaneously including instructing and counseling patients regarding Fairview Health Services payment policies and public assistance programs.
Must possess the ability to communicate effectively with patients, families, government entities, insurance companies, and Fairview Health Services staff.
Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served.
Communicates in a respective manner.
Ensures a safe, secure environment.
Fulfills all organizational requirements.
Completes all required learning relevant to the role.
Complies with and maintains knowledge of all relevant laws, regulation, policies, procedures and standards.
Fosters a culture of improvement, efficiency and innovative thinking.