Manager of Revenue Cycle (Hybrid)

Main Duties & Responsibilities

• Ensures claim processing by outside vendor is timely; monitors key indicators such as clean claim rate, denials, and rejections.
• Works collaboratively with outside vendor and internal key stakeholders to ensure timely, accurate billing.
• Aids CFO in Revenue cycle reporting and monitoring of outputs and trends.
• Aids and collaborates to facilitate clean claim submission and timely payment with multiple insurance carriers as well as credentialing with insurance carriers, partner hospitals, and Erie Family Health Center.
• Collaborates with Finance team members, clinical, operations, Information Technology staff, and outsourced revenue cycle partner and other Revenue Cycle consultants as appropriate in the development and enhancement of all billing and revenue cycle processes and systems to allow for the most effective billing and collection of all patient-related revenue activities.
• Aids CFO and Erie leadership in development and execution of managed care strategy, including contract review negotiations.

Qualifications

• Education Required: Bachelor’s degree required.
• Experience: Minimum five (5) years progressive healthcare billing and revenue cycle experience.
• Skills And Knowledge Required: Overall revenue cycle knowledge and billing familiarity; Medicaid, Medicare, Managed Medicaid, Commercial payment regulations, as well as electronic billing; Knowledge of Medical terminology, patient registration, CPT-4, ICD-9CM/ICD-10, HCPCS Level II, and Modifiers; Knowledge-based: Knowledge of: Medical terminology, patient registration, CPT-4, ICD-9CM/ICD-10, HCPCS Level II, and Modifiers; Interpret Remittance Advices and Explanation of Benefits; Understanding Medicaid and Medicare denial and rejection codes; Billing knowledge to facilitate clean claim submission; Skill based: Ability to: Communicate effectively with a variety of internal and external parties; Liaise effectively between Erie operations and outside revenue cycle vendor; Analytical skills and ability to process large volume of data; Strong Excel proficiency needed.
• Preferred: Medical Claims billing process; AMA Guidelines and HIPAA Compliance; Epic or similar EHR experience preferred.

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We do things well.
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