Professional Revenue Cycle Manager

Brown Medicine

2d•$100,027 - $165,048•Onsite

About The Position

Under the guidance of the PB Director of the Physician Revenue Cycle, the Professional Revenue Cycle Manager provides strategic support in the management of third-party payer relationships, ensuring timely and accurate claims submission and reimbursement across various insurance payers, including governmental or third-party agencies. This role actively plans, develops, organizes, and manages multiple areas of responsibility as assigned by senior leadership, guiding managers and/or supervisors in their performance to meet/exceed key performance indicators related to financial metrics, regulatory compliance requirements, and organizational strategic goals. Manage financial initiatives related to billing and collecting revenue for medical services. Ensures claims adhere to appropriate coding and billing requirements, detects erroneous claims, and resolves any disputes related to payment. This encompasses the secure transmission of electronic health records. Ensures PFS Managers, Supervisors and staff are following appropriate and consistent workflows. Brown University Health employees are expected to successfully role model the organization’s values of Compassion, Accountability, Respect and Excellence, as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate In addition, our leaders will demonstrate an aptitude for: Ensure Accountability and Build Effective Teams Drive Vision and Purpose and Optimize Work Processes By applying core and leadership competencies, leaders help Brown University Health achieve its strategic goals.

Requirements

Requires practical experience in leading and managing the execution of processes, projects and tactics within a job family group and/or job family; possesses advanced experience and skills.
Five to ten years’ progressive management experience in Patient Financial Services related responsibilities.

Nice To Haves

Bachelors preferred but not required: in business, healthcare or health services administration, health information management, communications, finance, accounting, public administration, or management.

Responsibilities

Actively manages, plans, develops, and organizes multiple areas of responsibility as assigned by Senior Leadership.
Practice excellent time management to be available to attend meetings for Leadership of all responsibilities.
Oversee the account receivables of all areas of professional net revenue operations.
Strategically monitors, develops and implements ways to protect the financial stability of professional revenue.
Supports, develops, and analyzes account receivable reports and provides findings to the Director of the Physician Revenue Cycle on a frequent basis.
Oversees insurance payors to ensure timely, accurate claims submission and claims reimbursement.
Reports, analyzes, and monitors accounts receivable for all payors, communicating findings to leadership with status updates or escalation as needed.
Assess and understands business processes of the Revenue Cycle from registration to billing operations.
Anticipates needs of the department and pursues solutions.
Displays extensive historical and current knowledge of information system technologies and our internal systems to ensure optimum efficiency in department’s operations.
Responsible for managing or participating in meetings with payers (JOC – Joint Operating Council), practice leadership, OP Denial Team and other Revenue Cycle departments.
Provides appropriate planning to address payer payment issues and creates new ways to mitigate risks.
Is active in various meetings within PFS to ensure continued focus and improvements in our patient and insurance collection practices.
Participate in Denial Management, Contract Management, Agency Tracking, external business partner meetings, and various other committees for PFS department.
Guided by departmental action plans and strategic priorities, impacts own and other teams’ ability to achieve service, quality, and timeliness of objectives
Performs other duties as assigned.