Revenue Cycle Job Description
Revenue cycle
provides leadership and managerial support to pre-registration, registration, residual collections, bed placement, and insurance eligibility/benefits verification, pre- authorization, community wide scheduling, and financial counseling.
Revenue Cycle Duties & Responsibilities
To write an effective revenue cycle job description, begin by listing detailed duties, responsibilities and expectations. We have included revenue cycle job description templates that you can modify and use.
Sample responsibilities for this position include:
Business acumen – ability to quickly and accurately understand key business drivers across the company
Provides day-to-day support to projects occurring within the Revenue Cycle including, patient registration, coding, billing, collections, denial management/avoidance, reimbursement, and clinical departments
Resolve complex problems, such as charge corrections, that require a high level of expertise and knowledge of the GE Practice Management system
Implement new processes developed by management to ensure effective and efficient operations
Assist healthcare organizations to effectively manage revenue performance
Review, handle, develop and track tools and a system to handle insurance rejection, denials, develop and appeal system
Generate aging report, follow-up outstanding claims within pre-defined time frame, and write appeal letters for denied claims
Oversee the process and accuracy of monthly end reports
Provide trend analysis to departments to help forecast future decisions
Build a crosswalk database by payers to forecast new reimbursements
Revenue Cycle Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Revenue Cycle
List any licenses or certifications required by the position: CPC, CCS, PMP, HFMA, NAHAM, EPIC, RHIA, CPA, RHIT, HB
Education for Revenue Cycle
Typically a job would require a certain level of education.
Employers hiring for the revenue cycle job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and High School Degree in Business, Health Care, Management, Public Administration, Education, Finance, Healthcare, Accounting, Associates, Business/Administration
Skills for Revenue Cycle
Desired skills for revenue cycle include:
Medical terminology
Business
Registration
Management
Public Administration
Computerized Systems
Word-processing and spreadsheet software
Insurance verification and payment processing programs
Outpatient operations
Various scheduling
Desired experience for revenue cycle includes:
Develop and meet the revenue cycle department company benchmark and billing systems to identify revenue enhancement opportunities
Manage/Analyze and identify top denied claims by insurance companies and CPT Codes, and ensure reasons for denials are corrected
Monitor aged accounts and verifies appropriate collections procedures are being followed
Manage revenue cycle projects at the Practice level
Strong knowledge of New York State Medicaid programs and regulations
Experience with Article 28 Facility billing
Revenue Cycle Examples
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Revenue Cycle Job Description
Job Description Example
Our innovative and growing company is looking for a revenue cycle. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for revenue cycle
- Production of the monthly statistical and analytic reports for the Patient Business Services department other corporate entities
- Serve as a liaison to cross-divisional teams and management as necessary
- Oversees processes involved with Denial Management and performs monthly analysis to identify trends and training needs
- Oversees the management of select revenue cycle personnel
- Escalate high risk accounts to management in a timely fashion
- Establishes vision and identities goals and priorities for management staff
- Resolves escalated reimbursement issues with Payers, Practices, US Oncology and systems for optimal management of accounts receivable
- Strong analytical skills combined with strategic thinking and problem solving ability
- Ability to thrive in ambiguity and drive results with minimal direction
- Ability to work effectively, build trust, and partner at all levels of the company – from front line teammates to senior executives
Qualifications for revenue cycle
- Strong written, verbal, and interpersonal skills, particularly when up against tight deadlines and in times of stress/changing priorities
- Demonstrated leadership skills and ability to work independently member of a team to foster a positive work environment
- Personal values in line with DaVita’s core values of Service Excellence, Integrity, Team, Continuous Improvement, Accountability, Fulfillment and Fun
- Requires communication skills to clearly and concisely communicate verbally and in writing with peers, superiors, payers, physicians, ancillary departments
- High school diploma or GED, additional training beyond high school preferred
- Previous experience with GE Centricity (IDX) and/or EPIC preferred
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Revenue Cycle Job Description
Job Description Example
Our company is growing rapidly and is searching for experienced candidates for the position of revenue cycle. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for revenue cycle
- Potential 4 hours flexing one day each week
- This position will also be held to an on-call schedule 1-2 days per month and be required to work 3 holidays per year
- Determine insurance company and financial status classification
- Determine priority of work and work collaboratively with clinical staff in processing of paperwork, lab requests, patient requests
- Saturday and Sunday weekly
- Supervise work of Patient Account Representatives and/or Revenue Cycle Representatives
- Serve as a payer reimbursement expert and technical resource
- Develop new and current staff through training and mentoring to increase revenue cycle knowledge
- Gather and respond to requests for information in response to benchmark surveys or questionnaires required by external agencies
- Generate monthly and ad hoc reports for PFS Leadership
Qualifications for revenue cycle
- Can identify major types of coverage, associated claims and payment processes
- Is aware of the payer's claim settlement practices
- Can identify the major activities of the claims function
- Understands basic principles, techniques and terminology of dental and medical claims processing
- Can identify major types of coverage and associated claims
- Is aware of the company's claim settlement philosophy
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Revenue Cycle Job Description
Job Description Example
Our company is looking to fill the role of revenue cycle. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for revenue cycle
- Utilize pattern analytics, industry best practice trends and commonly accepted business practices and tactics to yield highest impact recommendations available
- Participate in continual education programs and activities that pertain to healthcare management, specific functional areas
- Direct and oversee the operations of patient access, case management, health information
- Understands all payer guidelines related to claim submission
- Supports patient care by resolving pre-authorization issues with physicians, radiologists, radiology technologists, and ancillary staff
- Develop and monitor employee performance goals to enure compliance
- Develops work standards, monitors quality and quantity of work processed, and ensures that policies are communicated and administered consistently
- Meet or exceed applicable productivity and accuracy standards in each area deployed
- Maintains focus on attaining productivity standards
- Delivers a positive patient experience
Qualifications for revenue cycle
- Proficiency with computer software applications, Microsoft Office Suite (Excel, Word, Outlook, PowerPoint) or comparable programs and an ability to quickly learn and apply new systems knowledge
- Understands basic principles, techniques and terminology of claims processing and reimbursement
- Describes the implications of the law to own function
- Participates in implementing adherence to specific aspect of this law
- Describes major HIPAA-related challenges to the organization
- Identifies relevant procedures that demonstrate HIPAA adherence
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Revenue Cycle Job Description
Job Description Example
Our company is looking to fill the role of revenue cycle. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for revenue cycle
- Maintains strict adherence to and compliance with all internal and external policies, procedures, rules, regulations, HIPPA privacy laws
- Performs data quality review as needed
- Provides solutions to leadership and educators which are identified through daily work activities
- Assess revenue cycle performance in accordance with set goals and objectives
- Monitors effectiveness of software, vendors, payers
- Manages Practice-wide projects including any legal requests
- Responsible for quality work, meeting deadlines, and adherence to the Practices Standard Operating Procedures (SOPs)
- Monthly, prepares revenue cycle financial analysis, including aged accounts
- Develops, implements, and maintains the Practices revenue cycle training materials
- Attracts high caliber people, accurately assesses strengths and development needs of employees
Qualifications for revenue cycle
- Describes types of plan conversions in compliance with HIPAA guidelines
- Experience with patient accounting systems and billing/claim submission software
- Basic knowledge of healthcare billing (healthcare revenue cycle)
- Previous experience in selling revenue cycle and operation improvement solutions and Consulting Services to the larger Health Provider profit, not for profit and academic clients
- 2-3 years experience with medical billing/collection
- Living in or willing to relocate to Malvern, PA, or Kansas City, MO
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Revenue Cycle Job Description
Job Description Example
Our company is looking for a revenue cycle. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for revenue cycle
- Analyses data, prepares and presents project reports for management, clients or others
- Review treatment transactions and submit claims to insurance and/or third party payers
- Provide financial counseling to patients and families
- Determine if appropriate payment has been made by various entities and work with patients and insurance companies to obtain correct payments
- Appeal claim payments and/or denials
- Meet targets set by supervisor regarding assigned areas of the revenue cycle
- Identify trends and submit to supervisor to facilitate opportunities for process improvement
- Utilize new tools and processes to maximize the efficiency of the revenue cycle
- Comply with the established cash handling policies of the department
- Compile results of work list and other revenue cycle reports and submit to supervisor
Qualifications for revenue cycle
- Related industry certifications (CHFP, CRCR, CRCE, CRCP, PMP)
- 5 years of related and progressively more responsible work experience in medical practice billing, preferrably in an environment that spans multiple practices and specialties
- Extensive experience with billing software
- Basic knowledge of and experience with Electronic Medical Records systems
- Certification equivalency by MGMA and/or coding certification preferred
- Knowledge/experience utilizing the Epic software system preferred