REVENUE CYCLE MANAGER-MSH-78319-003

Mount Sinai Health System•New York, NY

21d•$78,884 - $135,665

About The Position

Reporting to the Faculty Practice Administrative Director, the Revenue Cycle Manager is responsible for the revenue cycle business needs and mission of the Icahn Mount Sinai School of Medicine’s Elmhurst and Queens Faculty Practice Groups. The manager oversees the Article 28 multi-specialty physician group and establishes and maintains procedures to maximize charge capture, billing, accounts receivable follow-up, and resolution of edits and claim denials within payor timely filing guidelines. The role also serves as a liaison with external third-party business partners to protect the Faculty Practice Groups’ best interests. The position oversees vendor performance and revenue cycle processes, works with clinical and administrative leaders and billing vendors to improve performance and collections, and supports timely claim submission and reimbursement. It also addresses patient professional billing issues, monitors applicable reimbursement regulations, and maintains patient privacy and confidentiality.

Requirements

Bachelor’s degree.
Five years of Revenue Cycle supervisory experience.
Comprehensive knowledge of Government and Third-Party Payors.
EPIC PB Revenue Cycle, ERM, and Reporting knowledge.
Strong Excel skills.
Microsoft Business skills.
Excellent written and oral communication skills.
Exceptional attention to detail and accuracy.

Nice To Haves

Master’s degree preferred.
Certified Professional Coder (CPC) or another professional billing certification preferred.

Responsibilities

Monitor and evaluate external billing vendor performance using KPIs, including Days in Accounts Receivable, Net Collection Rate, clean claim rates, and denial rates.
Audit vendor-submitted claims and payment postings, and recommend denial management workflows to ensure accuracy and minimize revenue loss.
Work with the billing vendor to create and analyze revenue cycle processes, improve workflows, and maximize collections.
Identify areas for improvement in Accounts Receivable management and review claim rejections and denials to support timely payment.
Meet with Directors of Service, physicians, and the billing vendor to discuss departmental key performance indicators.
Work with managers and coding staff to prioritize daily workflow and ensure timely claim submission.
Follow up with the billing vendor to identify outliers and ensure they are processed for billing.
Standardize customer service functions and evaluate front-end edits, providing feedback to facility administration on workflows such as registration and pre-authorization.
Manage and troubleshoot provider enrollment and credentialing workflows to prevent impacts on claim submission and timeliness.
Work with the vendor and management team on special claims projects, creating reports for submission according to payor-required templates.
Work with Faculty Practice Group staff and the billing vendor to identify and correct edits generated by the billing platform, coding staff, clearinghouse, or Accounts Receivable team.
Assist patients with professional billing issues and resolve complaints as necessary.
Stay current on state and federal regulations governing reimbursement of physician services.
Maintain the privacy and confidentiality of patient information.
Perform other related duties as necessary and required.