Revenue Cycle Manager

San Francisco Community Health Center•San Francisco, CA

About The Position

San Francisco Community Health Center [SFCHC] is a Federally Qualified Health Center (FQHC) providing culturally competent, high-quality medical care, mental health services, education, and outreach. The Revenue Cycle Manager (RCM) oversees the financial flow of patient services at SFCHC. The Manager is crucial to the cash flow improvement of SFCHC through accurate coding, timely billing and collections, denial management and effective patient accounts management. RCM collaborates with clinical operations on patient eligibility and insurance verification to securely compile accurate billing information. The RCM commits to the highest level of patient confidentiality in adherence to HIPAA and Protected Health Information [PHI].

Requirements

Deep understanding of billing and coding policies and procedures in the healthcare sector, preferably in a federally qualified health clinic[s]
Exceptional analytical and problem-solving skills to identify areas of revenue weakness and gaps and devise strategies to increase revenue
Excellent communication skills to clearly explain coding errors to clinical providers
Good understanding of medical billing software and other relevant applications
Strong ethical standards to ensure compliance with all relevant laws, regulations and industry standards
Ability to handle multiple tasks and prioritize workload for efficient management patient billing issues and other concerns related to revenue cycle
Detail-oriented with the ability to maintain accurate and thorough financial records
Fully vaccinated against COVID-19, complete with booster shot(s) and able to show proof of vaccination
Up to date with vaccinations, especially seasonal flu shot vaccine
Proof of TB clearance (issued within the past 12 months or less)
Comfortable and culturally competent in working with LGBTQ communities

Nice To Haves

Certification in billing or medical coding is highly desirable

Responsibilities

Reconciles all receivable and patient service revenue reports, working closely with the Controller on producing monthly financial reports
Creates patient revenue, visit utilization and productivity provider, by financial class and payer weekly, monthly and year-to-date
Tracks metrics, such as visits or encounters, charges, denials and rejections, coding error rates, patient engagement and billing turnaround times
Meets weekly with clinical operations to ensure charges are closed, captured and coding issues are resolved
Creates weekly patient revenue reports, payments and adjustments, denials and rejects, productivity and utilization
Serves as main contact for third-party billing [OCHIN], DHCS-M-CAL, CMS-Medicare, clearing house vendor [Tri-Zetti] and commercial insurances
Sets the annual fee schedule and the publication of Sliding Fee Discount table in accordance with federal poverty guidelines
Implements coding changes and provides up-to-date education for clinical, billing and coding staff on CPT and ICD-10 coding trends
Develops, evaluates, revises and implements polices and procedures related to billing, coding, rate reimbursements and improvement strategies
Meets with the 3rd party outside service [Ochin Billing Services] weekly, ensuring that invoices for clinical services are processed accurately and timely
Keeps abreast of all reimbursement billing procedures and regulatory requirements
Monitors and accounts for collection adhering to SFCHC bad debts and write-offs policy
Participates in negotiating contracts with payers and maintaining relationships with insurance companies