Revenue Cycle Manager

Franklin County Memorial Hospital•Meadville, MS

About The Position

Revenue Cycle Manager is responsible for overseeing each department with regard to revenue activities, organizing strategies to increase profitability, and meeting all financial objectives for the hospital, clinics, and DME office. Revenue Cycle Manager is in charge of exploring and reviewing billing activities and generating ideas for better practices regarding revenue programs, and monitor projections based on past financial results and analyze financial trends in order to modify company expectations as needed.

Requirements

High school diploma required
Five (5) years prior experience in a hospital or physicians billing office
Management experience required
Knowledge of claims submission for insurance, Medicare and Medicaid
Requires multi-tasking
Extensive customer service skills
Ability to handle stress in a fast paced working environment
Integrity in maintaining confidential information
Problem solving and troubleshooting of billing issues
Convey a positive, professional image

Nice To Haves

two (2) years college preferred
RHC and Critical Access knowledge preferred

Responsibilities

Assist in implementing the day-to-day functions of the billing department
Monitor and assist in completing day-to-day operations when an employee is out
Assist in planning, developing, organizing and implementing written policies and procedures
Organize, evaluate and monitor billing and admission office operations and employees in accordance with our established policies and procedures
Ensure administrative functions are carried out promptly for efficient operation
Interpret facility policy and procedures to personnel and patients as directed
Accumulate, maintain and provide statistical data on the hospital and clinics
Manage and maintain patient statement processes, and Cycle Bill processes
Monitor Accounts Receivable
Make sure efficiency is maintained with claim billing processes
Monitor claim rejections and denials for trends and possible oversights
Approve or deny claim administrative adjustments
Monitor Contract Bill accounts to maintain patient privacy with regard to contract bill accuracy
Run monthly Create Claims By Charge Period Reports for accurate cycle billing
Credentialing of all provider and facilities with networks and insurance companies
Submit Medicare and Medicaid credit balance reports quarterly to the appropriate agency
Collect and Submit the required patient admit and d/c health care information quarterly to the MS Department of Health via the IODS Submission system.
Gather and send appropriate accounts to Collection Service monthly
Write Off appropriate accounts to Regular Bad Debt and to Medicare Bad Debt monthly
Understand insurance billing and maintain correct billing processes throughout CPSI
Understand and assist in federal and state mandated reporting processes (MU, PQRS, MIPS, etc)
Stay informed and educated on the latest Medicare and Insurance billing rules.
Assist patients with understanding their accounts, as well as taking payments from them over the phone
Advocate on behalf of our hospital and our patients with insurance companies with regard to correct billing procedures and payments, as well as with refunds
Keep updated on cost report rules, so that I can help with reporting processes
Approve or deny sliding fee scale and charity applications, as well as verify appropriate documentation for such
Understand and be proficient at CPSI tasks and procedures so that account errors from any department can be caught and corrected before claims get dropped to billers
Oversee and educate employees on registration errors
Add and update users to myaccessblue.com(BCBS website), MESA(MCaid website), unitedhealthcareonline(UHC site) and Novitasphere(MCare eligibility) and claims site