Sup, Rev Cycle Mgmt, Hospital

Job Location: 601 Elmwood Ave, Rochester, New York, United States, 14642

Full-time, 40 scheduled weekly hours. Hybrid remote options available after in-person training; occasional onsite meetings at Rochester Tech Park (RTP), Gates, NY required. Remote location must be within 2 hours of RTP and within New York State.

Compensation Range: $25.14 - $35.24 per hour. Individual salaries will be determined based on factors including market data, education, experience, qualifications, expertise, and internal equity considerations.

Responsibilities

• Organizes and conducts operations affecting the revenue cycle (e.g., billing, collections, payment processing).
• Develops and implements processes to meet revenue cycle goals in collaboration with medical practices.
• Conducts training, monitoring, analysis, and reporting on revenue cycle processes and results.
• Develops and implements practice-specific process improvement recommendations.
• Coordinates and supervises the daily activities of a support, production, or operations team, setting priorities to ensure task completion.
• Provides overall supervisory, technical support, and direction to the team.
• Trains staff on contract language by payer to ensure appropriate reimbursement and accuracy of account reconciliation.
• Monitors compliance with timely filing requirements and takes corrective action if guidelines are not followed.
• Maintains knowledge of current third-party coverage, federal and state billing, reimbursement, and compliance regulations.
• Serves as a contact to answer questions, solve problems for difficult and unusual accounts, and assist in problem identification and resolution.
• Reviews, compiles, approves, and submits patient refunds and complete balance transfers.
• Reviews mid-dollar report for approval for write-offs.
• Ensures timely responses to requests for information from patients and external contracting agencies.
• Prepares team operational reports and special reports to identify key indicators using specific criteria measuring quality, quantity, and timeliness.
• Reviews weekly and monthly quality indicators in the billing area with staff, initiating corrective action or recommending solutions as needed.
• Prepares specific reports with payers to identify accounts requiring provider intervention and resolves flagged reports to ensure timely claim submission.
• Monitors and ensures worklists are completed in a timely manner.
• Monitors cash flow, receivables, Hold Bills, Claim Edits, aging reports, payment, and denial worklists.
• Performs monthly audits of account notes and adjustments.
• Attends monthly team meetings with the Outpatient Manager and appropriate payer representatives.
• Runs, distributes, and ensures resolution of accounts on reports.
• Develops audit procedures within the billing area to ensure payments from third-party payers align with negotiated contract rates.
• Ensures timely processing of secondary credit balances for government plans.
• Reviews reports generated within billing systems to ensure accuracy and reconciliation.
• Coordinates and provides support for all internal and external billing audits, reviews, or projects.
• Provides training, coaching, and reinforces billing and customer service skills to team members to ensure exceptional service.
• Seeks feedback from other departments to improve processes and service levels.
• Communicates with other departments regarding problem visits.
• Develops goals, objectives, and operating policies and procedures for the billing team in collaboration with leadership.
• Develops cross-training programs within the outpatient billing area and adds policies and procedures to the Patient Accounts shared drive.
• Completes performance evaluations for designated staff.
• Screens, reviews, interviews, and makes recommendations for new hires.
• Handles time reporting requirements in accordance with state and federal regulations.
• Addresses personnel disciplinary issues.
• Represents the department at meetings and seminars, as appropriate.
• Provides cross-coverage for leadership peers in other department areas, as needed.
• Represents the department on various internal and external committees, as needed.
• Attends continuing education seminars offered by local payers, Medicaid, and Medicare.
• Performs other duties as assigned.

Requirements

• Bachelor’s degree and 2 years of relevant experience required.
• Equivalent combination of education and experience will be considered.