Revenue Cycle Operations Manager

SBHU•East Setauket, NY

13h•$98,000 - $109,000

About The Position

The Revenue Cycle Operations Manager for Patient Financial Services (PFS) will evaluate business processes, anticipate requirements, uncovers areas for improvement, and develop and implement solutions across the department. Additionally, this position will lead the design, development and implementation of best practice guidelines within systems and/or policy and procedures to achieve workflow efficiency across the department. Successful candidates will be able to access and manipulate data, have critical thinking skills and will possess an ability to guide and train PFS staff in the completion of projects across the department.

Requirements

Bachelor’s degree and 5 years revenue cycle, medical billing or follow-up experience. Or , in lieu of degree, at least 9 years healthcare revenue cycle experience.
Proficient in MS Office Suite including; Excel, Word, Access, Visio, PowerPoint (Power Query; BI).
Knowledge of Invision Patient Accounting, Contract Management and/or Claims Scrubber software.
Experience reporting from healthcare decision support, patient accounting, contract management and/or claims scrubber systems.
Knowledge of CPT, HCPCs and ICD-10 coding principles.
Expert knowledge of inpatient and outpatient billing requirements (UB-04, 837i); specifically how claims information impacts and drives reimbursement.
Expert knowledge of Medicare, Medicaid and Commercial reimbursement methodologies.
Intermediate to advanced proficiency in SQL or Database reporting queries.
Demonstrated analytical skills-ability to break down and quantify problems and processes.
Excellent written and verbal communication skills.
Demonstrated ability to manage a process and timelines effectively.

Nice To Haves

Master’s degree in Accounting or Finance, Health Information Management, Health Administration, Computer Science or related field .
Medical Coding Certification through the American Academy of Professional Coders (AAPC), and/or the American Health Information Management Association (AHIMA).
Revenue cycle supervisory or managerial experience.

Responsibilities

Leads the analysis implementation and maintenance of revenue cycle best practice processes and activities across the department and ensures goal setting and project tracking.
Develops and monitors staff work queues and productivity to ensure work volumes and staffing are aligned.
Audits staff work and participates in developing and delivering training programs within the department.
Creates system and processes audit plans.
Resolves discrepancies, as required.
Troubleshoots issues and resolves concerns, as well as recommends necessary fixes.
Advises management of results and recommends actions.
Prepares data analysis for departmental leadership in organized format to clearly convey trends and identify key areas for revenue optimization.
Creates reports to evaluate accounts receivables, operational productivity and departmental outcomes.
Analyzes data trends to determine the root cause and conducts deep dive sampling.
Provides a detailed assessment of revenue cycle processes with a focus on process improvement and best practices.
Monitors and tracks ongoing departmental performance through key performance indicators (KPI) in comparison to industry benchmarks.
Cultivates effective collaborative relationships with departmental teams to seek resolution of issues identified through monthly monitoring of KOIs / KPIs.
Works closely with Department management to facilitate root issue remediation.
Collaborates closely with peers to develop, validate, and maintain meaningful report sets.
Maintains knowledge of Medicare, Medicaid and Commercial reimbursement.
Stays abreast of group payer contracts, payer policies, payer plans, and member benefits.
Keeps apprised of rules and regulations affecting reimbursement.
Manages special projects and duties as needed, or assigned.