Manager, Revenue Cycle & Audit
Under the general supervision of the VP, Operations, Physician Networks, the Manager of Revenue Cycle oversees the planning, organizing and coordinating of daily operations to ensure the effectiveness of charge capture, claims processing, and overall revenue for the AMG primary care, endocrinology and Physiatry practices and other ambulatory services as are added. This position also has oversight of revenue cycle billing and front desk operations to ensure revenue cycle effectiveness and efficiency, optimized collections and oversight of revenue cycle operations including front desk oversight (with the Director of Operations, AMG) of insurance verification and end of day close procedures.
Principle Duties and Responsibilities including Direct Reports:
Optimized revenue cycle performance based on standard revenue cycle metrics
Supervises the day to day revenue cycle operations in order to maximize the collection of medical services payments and reimbursements from patients, insurance carriers, and guarantors.
Responsible for insurance eligibility processes, claim submission and processing, payment processing, collections, accounts receivable management, and denial management.
Works with billing company to ensure efficient billing and collecting operations.
Responsible for the oversight of front desk operations to include insurance verification, co-pay/co-insurance collections, and end of day procedures
Responsible for managing all patient billing inquiries
Supervises billing staff
Maintains timely knowledge of mandatory billing and coding requirements
Responsible for occupational health and workmans compensation billing and collections
Verifies that fee schedules are appropriate against insurance payors, allowable fees, and expected reimbursement calculations are current accurately stated.
Performs analysis, identifies trends, presents opportunity areas, and prioritizes initiatives for performance improvement in a variety of areas, including but not limited to: coding, claim submission, insurance and self-pay collections, refunds and write-off approvals.
Routine Reporting of Key metrics include: AR days, cash collections, denials, avoidable write-offs, refunds, charge lag, bad debt, etc.
Coordinates with accounting to ensure accurate and timely month-end financial reports
Leads monthly meetings with Department Administrators and Physicians to review key metrics, trends and performance improvement opportunities (staff training, provider coordination, policy/process revisions, etc.)
Bachelor's degree in Finance, Business, Accounting or equivalent experience and 7 years experience in this field.
Four years outpatient medical revenue cycle experience required.
Two years' experience managing, delegating, and following up on work priorities of others is strongly desired.
Proficient in Microsoft Office, medical terminology, CPT & ICD10 coding
Extensive experience with Electronic Health Records Software
Experience with eClinicalWorks system preferred
Tobacco use is a well-recognized preventable cause of death in the United States and an important public health issue. In order to promote and maintain a healthy work environment, We will not hire applicants for employment who either state that they are nicotine users or who test positive for nicotine use.
We will withdraw offers of employment to applicants who test positive for Cotinine (nicotine). Those testing positive for cotinine are given the opportunity to re-apply in 90 days, if they can truthfully attest that they have not used any nicotine products in the past ninety (90) days and successfully pass follow-up testing.
Equal Employment Opportunity
We are an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.