Revenue Cycle Manager, Utah State Hospital

State of Utah Office of the Governor•Provo, UT

6d•$27 - $31•Onsite

About The Position

The Revenue Cycle Manager at Utah State Hospital leads end-to-end revenue operations and supports financial efficiency and community care. The position manages payer identification and verification, eligibility and benefits, authorization requirements, charge capture, diagnosis coding, claim submission, payer follow-up, payment posting, denials and appeals, account reconciliation, and collections. It monitors claims activity, investigates reimbursement issues, coordinates provider enrollment, analyzes health and reimbursement data, and prepares reports. The role ensures compliance with applicable laws, regulations, payer requirements, and organizational policies, and protects the confidentiality and security of patient information. This is a full-time, in-office position in Provo, Utah. The employee must reside in Utah or be in the process of relocating there within 30 days of the start date. A successful criminal history check is required. The typical setting is an adequately lighted, heated, and ventilated office. Work is generally performed sitting, with some walking, standing, bending, carrying light items, or driving; no special physical demands are required.

Requirements

Professional billing, coding, or health information management certification through AAPC or AHIMA, such as CPB, CPC, RHIA, RHIT, CCS, or equivalent, with demonstrated knowledge of CPT, HCPCS, and ICD-10-CM coding.
Experience researching, interpreting, and applying CMS manuals, transmittals, change requests, and other billing and coding guidelines.
Strong working knowledge of CMS-1500 and CMS-1450/UB-04 claim forms.
Familiarity with the National Correct Coding Initiative (NCCI), Local Coverage Determinations (LCDs), and National Coverage Determinations (NCDs).
Strong computer skills, including Microsoft Office Suite.
Excellent verbal and written communication, analytical, organizational, and problem-solving skills.
Ability to learn quickly, build and maintain long-term professional relationships, and work with minimal supervision.
Ability to independently manage competing priorities and complex revenue cycle functions.
Must reside in Utah or be in the process of relocating to Utah within 30 days of the start date.
Must successfully pass a criminal history check.

Nice To Haves

Revenue forecasting and projections.
Strategic planning for Medicaid, Medicare, and private insurance maximization.

Responsibilities

Manage end-to-end revenue cycle operations, including payer identification and verification, eligibility and benefits, authorization requirements, charge capture, diagnosis coding, claim submission, payer follow-up, payment posting, denial and appeals management, account reconciliation, and collections.
Monitor claims activity; analyze payment trends; research payer-specific discrepancies, underpayments, and other reimbursement issues; and implement corrective actions.
Coordinate and maintain provider enrollments with Medicare, Medicaid, and commercial insurance companies.
Analyze health and reimbursement data and prepare reports supporting internal and external financial activities.
Ensure revenue cycle activities comply with applicable federal and state laws, regulations, agency rules, payer requirements, organizational policies, standards, and guidelines.
Protect patients’ rights by maintaining the confidentiality and security of medical, personal, and financial information.
Exercise sound judgment and accountability in daily work.