Revenue Cycle Manager Job Description
Revenue cycle manager
provides direction for all areas of CAA’s professional services billing operation, including billing and collection, coding and compliance, reimbursement and third party contract compliance, and reporting.
Revenue Cycle Manager Duties & Responsibilities
To write an effective revenue cycle manager job description, begin by listing detailed duties, responsibilities and expectations. We have included revenue cycle manager job description templates that you can modify and use.
Sample responsibilities for this position include:
Provide education, training and direction to providers, clinical support staff and billing staff regarding documentation and coding requirements to support a compliant and accurate billing practice
Review and maintain the billing service description master, including bill code assignment in accordance with regulatory and third party payer guidelines
Maintain current and in-depth knowledge of government and third party payer billing regulations and guidelines
Facilitate the improvement in coding and clinical documentation practices that support appropriate billing and reimbursement for the level of service rendered
Provide training and education relative to regulatory and billing requirements and updates to all stakeholders
Work collaboratively with physicians/clinical staff to improve the quality of medical record documentation that supports reimbursement
Perform internal billing audits to ensure coding compliance, charge capture, and reimbursement based on medical record documentation consistent with payer regulations and guidelines
Establish baseline and ongoing measurements for documentation and coding compliance to measure ongoing improvements and/or identify opportunities for improvement
Gather and document requirements design, write, and implement test plans
Conducts compliance trend analyses from system reports, identifies gaps, and develops program components to mitigate identified gaps
Revenue Cycle Manager Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Revenue Cycle Manager
List any licenses or certifications required by the position: CPC, PMP, CCS, CAP, ACHE, HFMA, BLS, RHIT, RHIA, CCDS
Education for Revenue Cycle Manager
Typically a job would require a certain level of education.
Employers hiring for the revenue cycle manager job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and High School Degree in Business, Healthcare, Finance, Administration, Education, Accounting, Management, Business/Administration, Associates, Healthcare Administration
Skills for Revenue Cycle Manager
Desired skills for revenue cycle manager include:
Hospital Administration
Hospital registration/billing systems
Related hardware/software
Related Healthcare field as normally acquired through completion of a Bachelor’s Degree
Medical insurance billing and collections with CPT
Overall understanding of managed care products
Excel
PowerPoint
Insurance and third-party payor regulations
Desired experience for revenue cycle manager includes:
Provides daily support and subject matter expertise to Facility and Division leadership, and identifies areas of opportunity for continuous improvement including ongoing education and resources as needed
Partners with Client Managed Care Department to engage with different payors to provide feedback regarding trends and issues
Manage daily activities related to Patient Account Services underpayment functions
Assure that underpayment discrepancies are collected timely and accurately
Meet with payers to resolve ongoing payment resolution issues
Coordinate with Manager - Managed Care Reporting on contract issues related to underpayment discrepancies
Revenue Cycle Manager Examples
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Revenue Cycle Manager Job Description
Job Description Example
Our company is growing rapidly and is searching for experienced candidates for the position of revenue cycle manager. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for revenue cycle manager
- Assess team members for potential, strengths and development needs and conduct career development discussions to grow the talent pipeline
- Translate and oversee organizational strategies for assigned goals
- Investigate and partner with HR in the resolution of associate issues
- Manage the resolution of client issues and ensure appropriate follow-up is done to manage client relationship
- Manage & administer program policies & procedures
- May require periodic travel to sites or client related meetings
- Manages process for all external medical record requests (clinical, audit, legal, insurance)
- Runs reports, tracks operational and financial Revenue Cycle metrics (staff productivity, quality, ), Key Performance Indicators (Appointment no show rates, charge lag, net collections, net days in receivables, denials as a % of revenue, bad debt, cost to collect, ), and patient-level data (e.g., types of patients, diagnosis, etc)
- Collaborates with Financial Clearance and Billing Managers to audit samples of patient accounts on a monthly basis to ensure accuracy of financial clearance, charge entry, payment posting, and denial management follow-up procedures
- Define and document scope and objectives with project sponsors across the revenue cycle
Qualifications for revenue cycle manager
- Identify & generate proposals for potential projects to improve processes, cost to collect and cash yield
- Develop and manage revenue cycle project dashboards, results and benefits realization, track progress, identify opportunities to accelerate implementation plans or create corrective plans as needed
- Provide guidance to and support to the revenue cycle organization on change management and performance improvement strategies
- Evaluate Revenue Cycle department processes and procedures
- Participate in requirements gathering and implementation of new IT applications
- Bachelor's Degree in Nursing, Medicine, Accounting or Finance
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Revenue Cycle Manager Job Description
Job Description Example
Our innovative and growing company is looking to fill the role of revenue cycle manager. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for revenue cycle manager
- Work closely with the Implementation team assigned to ensure proper system build and billing setup
- Follow up with clearing house enrollment and assist the practice/CH in the capacity of a facilitator of the enrollment process
- Manage a team consisting of auditors, analysts and data analytics professionals
- Administer the activities of the billing compliance program, including execution of the billing compliance work plan, quarterly review of departmental compliance monitoring reports, and ensuring compliance with Federal and State reimbursement regulations through training, monitoring and documented policies and procedures
- Participate in the annual billing risk assessment process to identify areas of focus for the Compliance Department’s annual work plan
- Throughout the year, routinely monitor the environment for new risks that may arise from internal or external factors and advise the Director
- Design and conduct audits, either as defined by audit plan or in response to an ad hoc report or discovery
- Assure the timely and effective conduct of audits in accordance with departmental standards
- Develop written reports, recommendations and collaborate with auditee department leadership to complete management corrective action plans based on audit results
- Develops and maintain standard operating procedures for assigned areas of responsibilities
Qualifications for revenue cycle manager
- Detailed knowledge of revenue cycle systems (IT, reporting, process flows)
- Manage Revenue Cycle Department
- Fluency in Arabic preferred
- Ability to manage multiple initiatives, identify and prioritize issues to meet aggressive deadlines and organizational goals
- Excellent supervisory, problem solving and decision making skills required
- Experience working with automated mainframe, personal computer and business software applications
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Revenue Cycle Manager Job Description
Job Description Example
Our growing company is hiring for a revenue cycle manager. 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 manager
- Monitors aged accounts and verifies appropriate collections procedures are being followed
- Identifies goals and vision for team
- Provide a central resource for front office processes, like intake, insurance verification, copay collection and charge entry
- Chairs Revenue Cycle Front Office task teams
- Deliver RCM and coding expertise against defined Product initiatives
- Maintain current knowledge of all applicable laws and regulations
- Serves as a liaison on behalf of the CBO Directors in order to enable process improvement activities and communications between the hospitals and CBO operations
- Monitor and evaluate team effectiveness and individual productivity measured against established performance standards
- Manage daily activities related to SSC overpayment discrepancy, refund and credit balance resolution functions, ensuring processes are performed effectively and efficiently
- Analyze trends in discrepancy coding and work to decrease incoming inventory
Qualifications for revenue cycle manager
- Must possess experience managing through direct reporting relationships through influence and collaboration with providers and executives, both inside and outside KP
- Must have experience developing and maintaining budgets and operating plans
- Skilled in team building, team participation, and achieving organizational success
- Minimum of 3 years of experience transforming revenue cycle processes to maximize realizable revenue, minimize denials and accelerate cash flow
- Prior experience working in consultancy or consulting capacity is preferred
- Asses opportunities to improve internal workflows
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Revenue Cycle Manager Job Description
Job Description Example
Our company is hiring for a revenue cycle manager. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for revenue cycle manager
- Coordinate project specific meetings and review work products for completeness and adherence to consumer request
- Provide leadership and direct teams in the delivery of high quality services within committed timeframes to the customer
- Decisive and innovative be able to take ownership
- Able to understand client needs provide purpose processes
- Strong familiarity with information technical concepts
- Ensure standardization across various programs
- Deep understanding of product capabilities and end to end-process understanding
- Communicates frequently with team members regarding project status and identifies and resolves project problems issues
- Manage large tasks with a high level of complexity and high risk
- Produce monthly statistical reports for management on billing-related tasks
Qualifications for revenue cycle manager
- Minimum two years of management experience within the revenue cycle functions in the healthcare, medical, or ambulatory surgery center industry
- Understanding of the various roles, responsibilities, and technical aspects of the entire revenue cycle, specifically in the healthcare, medical, or ambulatory surgery center industry
- Knowledge of medical terminology and health insurance billing
- Will require local travel
- Will require other travel for business needs
- Bachelor’s Degree required, Masters in Business or Healthcare Finance preferred
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Revenue Cycle Manager Job Description
Job Description Example
Our innovative and growing company is hiring for a revenue cycle manager. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for revenue cycle manager
- Prepare ad hoc analysis to assist hospital and corporate leadership in understanding the various elements impacting the Revenue Cycle
- Revenue Cycle oversight of the Practice Management Systems (Epic, Allscripts/PPMS, NextGen) data to assure system integrity
- Management of the team serving as the primary resource for the development of documentation templates and assignment of correct CPT/diagnosis codes to physician orders
- Analyzes and interprets data to initiate and facilitate implementation of solutions for process, quality and procedural improvements within the Enterprise Revenue Cycle by understanding Enterprise Revenue Cycle operations, processes, systems, regulations, clinical practice, payer changes and data
- Analyzes, designs, and redesigns processes, workflow, and systems to ensure quality, effectiveness and efficiency, identifies resource impact, and leads and facilitates process improvements by understanding system dependencies
- Participates in the design, development, testing, implementation, training and maintenance of new business process and system applications with Systems Services staff
- Leads effective meetings, workgroups, and committees which include participants throughout CHI to facilitate and negotiate issues with institutional impact
- Manage all physician practice and ASC billing, revenue cycle processes and vendor enterprise wide
- Ensure facilities are meeting coding compliance
- Ensure areas of responsibility for establishing policies and procedures
Qualifications for revenue cycle manager
- Prefer credentials related to Revenue Cycle or HIMS areas, such as RHIT, RHIA, CBCS
- At least five years of experience in medical practice Revenue Cycle operations required
- Experience utilizing and/or managing multiple practice management systems required
- Previous CBO experience preferred
- Excellent written and verbal and presentation skills
- Knowledge of ICD, CPT, HCPC coding, ability to read EOBs, post payments and refunds