Revenue Cycle Manager

Key Responsibilities

• Oversight of the entire billing workflow from intake and PCR review to claim submission, A/R follow-ups, and collections.
• Reviewing daily activities of patient accounts to ensure timelines and accuracy of revenue cycle processes.
• Ensuring accurate coding (HCPCS, ICD-10, ALS/BLS modifiers) and compliance with CMS and commercial payer guidelines.
• Leading responsibility for the revenue cycle operation pertaining to all pre-billing activities.
• Assisting in developing and implementing long-range plans, such as specific policies and procedures to solve operational problems.
• Monitoring key performance indicators such as days in A/R, collection rates, and denial rates to report on financial health.
• Updating Leadership with weekly reports and utilizing reporting to track performance and staff feedback.
• Tracking and evaluating specific staffing and performance levels needed to streamline operational steps and improve cash collections.
• Collecting, managing, and presenting data regarding accounts receivable, reimbursement, write-offs, and denials.
• Proactively identifying root cause of claim denials, executing appeals, and implementing strategies to prevent future rejections.
• Keeping self and staff abreast of any changes in state and federal government programs, as well as all other third-party payers.
• Maintaining knowledge of and complying with all company policies, procedures, and guidelines at all times.

Requirements

• Must be 18 years of age or older.
• Comply with UDS drug screening at any and all times.
• Satisfactory background check and MA CORI, verification required annually.
• Verification of an acceptable motor vehicle driving record, verification required annually.