Revenue Cycle Manager

Genesis Healthcare System•Moline, IL

4d•Onsite

About The Position

In order to fill our Mission of serving our community by helping each person achieve optimal health and well-being by providing compassionate, exceptional, and affordable healthcare services, all employees of Genesis HealthCare System must be committed to living the Genesis Mission and Genesis values of Compassion, Excellence, Integrity, Team, and Innovation. All employees must regard themselves as an ‘owner’ of Genesis and keep our patients at the center of everything we do - always. Position Details: Work Shift: Day Shift (United States of America) Scheduled Weekly Hours: 40 Department: Physician Billing Dept Overview of Position: Manages and directly participates in the performance of the revenue cycle operations of Genesis Hospital and Genesis Medical Group (GMG) to maintain a high functioning revenue cycle. Plans, organizes, and directs overall operations of patient accounting functions for both hospital and professional billing. Manages and directly supervises daily operations of the billing, follow up and denial processes. Determines work schedules, monitors performance, resolves technical and project issues and educates staff

Requirements

Bachelors degree preferred. In lieu of degree, 3-5 years of supervisory and field related experience is required, along with certification of achievement obtained within the first 18 months of employment.
Ability to motivate and organize people efficiently.
Excellent computer system knowledge and PC skills.
Ability to work under pressure and promote a positive working atmosphere.
Ability to lead and manage diverse staff in a learning environment with frequent changes in department priorities. Ability to recognize necessary changes in priority of tasks and allocation of resources, and act upon them as required to meet workload balance.
Possess good communication skills both verbally and written.
Excellent critical thinking, decision-making, problem solving, and analytical skills required.

Responsibilities

Oversees all practice revenue cycle activities through direct and matrix reporting relationships with office managers, office and billing staff, patient registration, and other support staff within revenue cycle process. Coordinates revenue cycle interaction with the operations and revenue producing areas and providers.
Responsible for the oversight, development, and implementation of strategy and tactical aspects of patient accounts, appeals management, financial assistance and payment posting processes.
Analyzes CMS memorandums and payor reimbursement methodologies (Commercial and Government). Performs research reviews of process changes associated with new regulations and implements a compliant process for the system.
Analyzes daily financial data to determine areas of leakage and partners with departments to optimize collections and improve the capture of compliant charges. Performs root cause analyses with trends to share with appropriate service line leaders.
Monitors and maintains receivables, days outstanding in account receivables to maintain cash flow and optimize collections.
Maintains billing system and edits to assure compliance to billing and regulatory requirements. Works with third party payors, handles patient complaints, conducts employee training and performance evaluations.
Liaison to all hospital departments as it relates to billing, coding, denials, and CMS coverage guidelines.
Develops, produces, and reviews the Performance Indicator Report, or other similar performance reports within EPIC, with Hospital and GMG administration and physicians to demonstrate revenue cycle performance and comparisons to targets and benchmarks.
Works collaboratively with office managers to ensure that physicians and office staff capture and report accurate billing information and follow revenue cycle related point-of-service policies, such as collection of co-pays, treatment of self-pay balances, and appropriate charity care designation.
Oversees training/education in relation to all aspects of the revenue cycle process, from registration and point of service through the collections and reimbursement process.
Analyzes trending and secures process improvements consistent operational improvements in account resolution.
Oversees the denial management process, including working with billing and denial staff to track and trend recoveries, and to ensure appropriate communication and follow-up activities.
Works with Coding Manager, Contract & Compliance Manager, and other Physician Services administration to monitor and coordinate responses to the latest regulatory billing/payment requirements of the federal, state and 3rd party payers to ensure GMG offices are in compliance and that electronic data processing (EDP) systems and coding structures are maintained to minimize manual processing and maximize claims acceptance and reimbursement. Translates regulatory requirements into daily operational procedures. Expedites payment processing and resolves problems with major 3rd party payers.
Maintains compliance with applicable federal, state, and local laws and regulations, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.
Researches and understands Regulatory requirements and maintains a consistent knowledge of payer changes, Governmental changes and/or billing requirements to ensure Genesis captures and is reimbursed correctly for all services provided.
Ensures all Medicare, Medicaid and Commercial guidelines are accurately administered for Genesis.
Prepares required reports using statistically sound information, displaying content in easily understandable format.
Secures data for month end scorecard metrics and builds action plans to meet and exceed targets.
Conducts team meetings for enhanced communication within Professional and Hospital patient accounts.