Revenue Cycle Manager

Family HealthCare Network • Visalia, CA

6h

About The Position

The Revenue Cycle Manager is responsible for leading and optimizing all aspects of the revenue cycle at Family HealthCare Network (FHCN), including billing, coding, collections, and patient accounts receivable. This role ensures timely, accurate, and compliant reimbursement while supporting organizational compliance, operational excellence, and patient-centered care.

Requirements

• Possesses specific advanced knowledge and skills, including written and verbal communication skills, computational, computer and technical skills, and mathematical knowledge frequently acquired through completion of a Bachelor’s Degree program with a recognized major or comparable experience, and;
• Four years of leadership experience or 5 years of progressively greater responsibility or significant contributions to projects and initiatives that demonstrate leadership skills.
• Experience in health care-related billing and coding regulations.
• Ability to prepare more complex documents in Microsoft Word, including creating tables, charts, graphs, and other elements.
• Ability to use Microsoft Excel to analyze data, including the use of formulas, functions, lookup tables, and other standard spreadsheet elements.
• Ability to develop sophisticated presentations in Microsoft PowerPoint, including the use of embedded objects, transitions, and other elements.
• Job duties require the employee to effectively communicate, verbally and in writing, their opinions and extrapolations of information they collect and synthesize/analyze.
• Responsible for the resolution of conflicts that may arise because of disagreements between employees, between employees and customers/clients, or with the public, other legal entities or governmental authorities.
• Compiles, analyzes, and prepares information in an effective written form, including correspondence, reports, articles, or other documentation.
• Effectively conveys technical information to non-technical audiences.

Nice To Haves

• Professional Coding Certification strongly preferred: AAPC (Academy of Professional Coders)-CPC Certification, AHMA (American Health Information Management Association)-CCS Certification, or PMI (Practice Management Institute)–CMC Certification.

Responsibilities

• Provides management to departmental staff.
• Responsible for performance management of assigned supervisors, and those supervisors’ assigned staff, including recognition, performance evaluations, formal coaching and counseling, and making decisions or recommendations regarding necessary disciplinary actions.
• Responsible for making recommendations regarding hiring or firing, and the advancement and promotion of assigned supervisors, and those supervisors’ assigned staff, or any other change status of assigned supervisors, and those supervisors’ assigned staff.
• Demonstrates core leadership behaviors and team one approach.
• Creates a culture of accountability and excellence.
• Develops and manages an action plan across assigned employee base to support the strategic direction and obtainment of goals of the organization, effectively leading change when necessary.
• Empowers staff through effective communication and talent building.
• Delegates appropriate departmental duties and responsibilities to assigned team members while ensuring department performance.
• Assists with the development of the departmental budget and monitors budget to ensure expenses do not exceed budget.
• Ensures regulatory compliance for assigned departments, and compliance with all workflows, policies, and procedures.
• Ensures department employees receive instruction/training that is in compliance with training plan, including on the job training to develop department employees and supervisor. Works with supervisor to ensure necessary remediation is taken.
• Recommends workflow, policy, and procedure changes based on observations from performance metrics, outcomes, and feedback from supervisor.
• Ensures department maintains compliance with all employee-related reporting and tracking.
• Responsible for overseeing the third-party billing and coding process for medical, dental, optometry, optical, and behavioral health visits. Also responsible for billing any inpatient activity for FHCN providers.
• Monitors coding of visits to ensure documentation matches what is in the medical records through regular audits of certified coders’ work.
• Ensures that CPT/CDT, ICD, and HCPCS codes are correctly linked as per National Correct Coding Initiative (NCCI) guidelines on all medical and dental claims through regular audits of certified coders’ work.
• Ensures timely and accurate billing of all claims and follow-up on errors and denials.
• Ensures that adjustments made to amounts billed are appropriate and accurate.
• Responsible for monitoring the master fee schedule, collection rates, and coding levels to ensure maximum reimbursements and cash flow are achieved.
• Oversees the set-up and optimization of the practice management system for the revenue cycle process.
• Responsible for the patient billing and collections process for the Network.
• Ensures timely and accurate billing of claims with patient responsibility, statement generation, and accurate follow-up of past due patient accounts.
• Ensures that the FHCN sliding fee scale accounts meet documentation requirements and the visits are billed in alignment with the sliding fee scale policy.
• Oversees the collections process for delinquent patient accounts.
• Ensures that payment plans and adjustments for patient accounts are appropriate.
• Responsible for the month-end close process.
• Ensures claims, payments, and adjustments are posted properly and into the correct month.
• Provides reporting data to the accounting department regarding month-end accounts receivable and contractual allowances.
• Responsible for preparing, reviewing, and submitting various revenue cycle reports.
• Reviews various productivity and error reports on a weekly basis.
• Prepares weekly and monthly operational and statistical reporting of billing operations, revenue cycle, and staff performance.
• Analyzes denials and other claim errors for financial classes and implements processes to decrease denial percentages against benchmarks.
• Performs other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager