MGR, Rev. Cycle Mgmt, Provider

University of Rochester•Town of Brighton, NY

3d•$70,197 - $105,295•Onsite

About The Position

The University of Rochester is seeking a Manager of Revenue Cycle Management for their Provider department. This role is responsible for managing the daily activities of the revenue cycle department, providing consultation for new services and products, revenue optimization, and analyzing key revenue cycle metrics. The position also involves assisting with regulatory guidance, implementing changes, and overseeing revenue cycle reporting. The manager may be accountable for a team of employees, including performance reviews, pay decisions, recruitment, discipline, and termination. The role is crucial for directing and managing the Billing, Claims, and A/R functions of the Revenue Cycle department at the Eastman Institute for Oral Health (EIOH), ensuring efficient operations and compliance with federal, state, and other regulations concerning Dental and Medical billing procedures.

Requirements

5 + years’ experience in billing/coding
3+ years in a management and supervisory position required

Nice To Haves

CPC or RHIT, CCS and nationally recognized billing certification (CMBS) preferred

Responsibilities

Manages the daily activities for the revenue cycle department.
Provides revenue cycle related consultation for new services and expanded products, revenue optimization projects, and analyzing variances and understanding and reporting on key revenue cycle metrics.
Assists in providing regulatory guidance as requested and implements any needed changes as required.
Assists in overseeing many aspects of revenue cycle reporting.
May be accountable for the budget, performance, and results of team of employees.
Exercises full management authority, including performance reviews, pay decisions, recruitment, discipline, termination, and other personnel actions.
Directs and manages the Billing, Claims and A/R functions of the Revenue Cycle department of the Eastman Institute for Oral Health (EIOH), responsible for the billing, insurance claims and Accounts Receivable operations of the Institute, supervises the related department managers and staff and the third-party insurer relations function.
Determines, develops, implements, and monitors policies and procedures to ensure complete and efficient charge entry, payment posting and accounts receivable management.
Determines departmental review processes to ensure compliance and productivity of billing staff.
Accountable for ensuring compliance with federal, state, and other regulations concerning Dental and Medical billing procedures and practices performed by the patient service providers of EIOH.
Monitors and assesses current operations to identify opportunities for performance and process improvements and provides a high level of problem solving to support continual change management.
Recommends improvements to the leadership team.
Implements approved changes and oversees staff training to ensure an understanding of quality/performance improvement initiatives.
Performs non-routine analyses on related issues and participates in various projects as directed by the Assistant Director of Revenue Cycle Management.
Develops and maintains reports and communicates the results of billing operations to the Assistant Director of Revenue Cycle Management.
Analyzes billing systems and procedures and recommends and implements changes for process improvements to maximize revenue.
Manages non-routine claim and payment issues.
Monitors accounts receivable and collection rates and take appropriate action to maximize reimbursement.
Updates billing systems to ensure fee schedules are current and aligned with CDT/CPT/ICD10 codes.
Reviews CMS, eMedNY and insurer regulations and policies to incorporate into dental and medical procedures and patient documentation as needed.
Trains staff in proper billing and coding procedures and compliance issues related to third party billing.
Is a key member of the leadership team working with third-party insurers to resolve payment issues.
Supervises functional groups related to billing, claims and A/R including hiring, training, and performance evaluations.
Provides leadership and training of staff in billing policies and third-party contracts.
Ensure compliance with federal, state, and other regulations concerning billing policies and procedures.
Assigns and monitors workflow to maximize efficiency.
Provides opportunities for cross-training and development of staff skills.
Monitors standard organizational metrics and utilizes data from all sources to create reports to meet the needs of all internal and external customers.
Analyzes detailed operational and financial data to identify billing and claim related issues in regular reporting to leadership.
Monitors effectiveness of resolution efforts and works with leadership team to develop and implement strategies to improve efficiency and decrease unbilled services across all payors.
Keeps current on relevant areas of knowledge and acts as a resource to staff.
Working in connection with the Compliance Department ensures compliance with regulatory standards and requirements.
Keeps abreast of regulatory requirements, professional standards, and competitive industry practices, as well as organizational initiatives with potential to impact current operations.
Monitors impact on existing activities to maintain service levels and work quality.