Manager, Revenue Cycle

Summit Health CityMD•Wethersfield, CT

1d•$68,000 - $77,000

About The Position

This role will be responsible for providing recommendations for process improvement within coding operations. Areas of oversight include manual charge capture, coding edit resolution, provider documentation and coding auditing and education. The manager will partner with leaders across the organization to develop plans that will improve the financial performance of our clients involving a high degree of analyzing and interpreting data and generating reports that present charge capture and coding improvement opportunities.

Requirements

Bachelor’s Degree in business, Accounting or another related field required.
Minimum of five (5) years progressive experience within physician healthcare receivables management in a complex academic medical center or multi-hospital system.
Experience with professional billing electronic health records.
Certified Professional Coder (CPC) certification and Certified Professional Medical Auditor (CPMA)

Nice To Haves

Master’s degree preferred.

Responsibilities

Collaborating with Summit management in the development of performance goals and long-term operational plans
Defining, implementing, and revising operational policies and guidelines for the organization.
Developing and executing new growth directives.
Provides direction and oversight of Revenue Cycle Operational Coding Services, including but not limited to, charge capture, billing, coding denials, vendor, and staff management.
Build and maintain relationships with all department heads, external partners, and vendors to make decisions regarding operational activity and strategic goals
Tracks and monitors key revenue cycle performance indicators; reports key findings to appropriate leadership and stakeholders across the organization
Ensures systems and processes are in place to ensure compliance with contract requirements around submission of claims; including service provision/documentation, established fee schedules, credentialing, and site enrollments
Partners with the Managed Care Team to manage payer contracts and support payer relationships
Provides oversight, in collaboration with financial leadership, on the general ledger close as it relates to revenue, accounts receivable and billing.
Ensure internal controls, policies and procedures are consistent state and federal law, compliance plans and HIPAA
Provides and/or supports project management of any EHR implementation/integration and other Revenue Cycle Management Initiatives
Oversees the analysis and recording of coding adjustments, write offs and denial activity; provides reporting on trends to management along with suggestions to mitigate future write offs and denied claims
Oversees vendor support services
Other duties as assigned.