Revenue Cycle Manager in Dallas, TX
FLSA Class: Exempt
Department: Revenue Cycle Management
Job Category: Management
Reports to: Chief Operating Officer
Summary Description: The primary responsibility of this role is to manage the client billing process, to oversee the credentialing process, and to provide leadership to the billing and credentialing departments. This includes having an exact knowledge of service fees, reimbursements from insurance companies, and
write‐off percentages of the insurance companies. This role directs the posting of invoices and collection of fees owed. This process involves specific communications with physician providers, insurance companies, state agencies and patients. It involves familiarity with the medical industry, policies, codes and specific medical records databases.
Essential Functions: To perform this job successfully, an individual must be able to perform the following satisfactorily; other duties may be assigned. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Serves as liaison between billing department staff, physician providers, and our internal management team.
- Acts as a resource to all departments regarding billing questions and concerns.
- Meets billing operational standards by contributing billing information to strategic plans and reviews; implementing production, productivity, quality, and customer service standards; resolving problems; identifying billing system improvements.
- Researches, negotiates with, and creates contracts with new and existing insurance companies. Monitors successful contractual compliance.
- Meets billing department financial standards by providing annual department budget information, monitoring expenditures, identifying variances and implementing corrective actions.
- Conducts regular meetings with physician providers to review status of physician claims and billing; addresses concerns; and resolves problems. Serves as subject matter expert to physician providers and an educational resource.
- Guides employee actions by researching, developing, writing, and updating billing policies, procedures, methods, and guidelines.
- Approves and monitors billing department expenses.
- Understands current regulations and keeps up to date on all changes as they relate to all 3rd party payers and other compliance criteria.
- Provides direct oversight of the day‐to‐day operations of the Credentialing Department, including overseeing all aspects of the credentialing and re-credentialing process.
- Understands and adhere to HIPAA policies, procedures and regulations to assure patient confidentiality.
- Works with the entire billing team to submit timely and accurate claims for reimbursement.
- Ensures that payments are posted as they are received.
- Ensures that follow‐up and collections on accounts with outstanding receivables are completed timely.
- Attends required meetings and participates in training programs as required.
- Understands and adheres to HIPAA policies, procedures and regulations to ensure and maintain patient confidentiality.
- Contributes to team effort by accomplishing related results as needed.
- Accomplishes departmental human resource objectives by selecting, orienting, training, assigning, scheduling, coaching, counseling, and disciplining employees; communicating job expectations; planning, monitoring, appraising job contributions; recommending compensation actions; adhering to and ensuring compliance with policies and procedures.
- Assists with special projects including the onboarding of new clients, and performs other duties as assigned.
Education: Bachelor’s degree in Business Administration or related field.
- 5 years revenue cycle experience.
- 2+ years management experience.
- Communicates effectively with all internal and external clients.
- Ability to handle high volume and stressful situation in a calm and professional manner.
- Ability to create department objectives and direct others to achieve those goals.
- Demonstrate good organizational skills.
- Excellent written and oral communication.
- Possess a strong work ethic and a high level of professionalism with a commitment to client/patient satisfaction.
- Microsoft Office Suite; Electronic Medical Record and Practice Management Systems including eClinical Works.
Supervisory Responsibility: Billing and Credentialing departments staff and supervisors.
- Achievement Focus -Demonstrates persistence and overcomes obstacles. Measures self against standard of excellence. Recognizes and acts on opportunities. Sets and achieves challenging goals. Takes calculated risks to
- Communications -Expresses ideas and thoughts verbally. Expresses ideas and thoughts in written form. Exhibits good listening and comprehension. Keeps others adequately informed. Selects and uses appropriate
- Managing Customer Focus -Develops new approaches to meeting customer needs. Establishes customer service standards. Monitors customer satisfaction. Promotes customer focus. Provides training in customer service delivery.
- Managing People -Develops subordinates' skills and encourages growth. Includes subordinates in planning. Makes self available to subordinates.
Provides direction and gains compliance. Provides regular performance feedback. Takes responsibility for subordinates' activities.
- Planning & Organization -Prioritizes and plans work activities. Uses time efficiently. Plans for additional resources. Integrates changes smoothly. Sets goals and objectives. Works in an organized manner.
- Problem Solving -Identifies problems in a timely manner. Gathers and analyzes information skillfully. Develops alternative solutions. Resolves
problems in early stages. Works well in group problem solving situations.
Work Environment: This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. Work is typically indoors. The noise level in the work environment is usually moderate.
Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing
the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is occasionally required to stand; walk; climb or balance and stoop, kneel, crouch, or crawl. The employee must regularly lift and /or move up to 10 pounds, frequently lift and/or move up to 25 pounds and occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
Travel: Occasional travel is expected of this position. Required to drive throughout designated area utilizing personal vehicle. Reliable transportation required along with valid driver’s license and automobile liability insurance acceptable to company.
Other Duties: This job description is not intended to cover or contain a comprehensive listing of activities, duties, standards or responsibilities that are required of the employee for this position. Duties, responsibilities and activities may change at any time with or without notice. Incumbents will follow any other instructions, and perform any other related duties, as assigned by their supervisor.