Business/Administrative Associate - Revenue Cycle Manager
- Oversee and manage all end-to-end revenue cycle operations, including charge capture, claims processing, denials management, collections, and accounts receivable. Supervises billing, coding, and collections staff, ensuring accurate and timely execution of all revenue-related activities. Is responsible for staff training, development, and performance evaluation to maintain a high level of efficiency and compliance. Additionally, the role involves establishing, tracking, and analyzing key performance indicators (KPIs) such as accounts receivable days and denial rates to identify opportunities for process improvement and to enhance overall cash flow and financial performance. Opportunities/outcomes are reported to leadership and used in long-range planning.
- Oversee and optimize Electronic Health record system (EPIC) driven metric information to ensure compliance with Medicare, Medicaid, commercial insurance, and Federally Qualified Health Center billing regulations. Perform audits to verify that appropriate documentation is being stored for transaction verification and implement corrective actions if needed.
- Develop a Quality and Audit process that maintains quality assurance processes and supports internal and external audits, regulatory requirements, and compliance initiatives. This includes oversight of program development and responsibility for managing the day-to-day operations of the revenue cycle. It represents the Medical Service Plan (MSP) and assists in data collection and analysis of the data to be presented at MSP Administrators' meetings.
- Directs business matters for the MSP. This includes continuous monitoring and updating fee schedules and financial assistance programs based on federal guidelines. Ensuring adherence to departmental budget, and specialized business/administrative correspondence (requests for legal action, refunds, requests for medical records, patient complaints, etc.), and participates in long-range planning, with a thorough understanding of the transactions occurring within a patient’s financial record.
- Oversees functions such as interviewing, selecting, training, evaluating performance, work schedules, and assignments.
- Performs other related duties and research. Serves as a resource, liaison, and subject expert for revenue cycle operations
- Bachelor's degree in business administration, management, or a field related to the position.
- Two (2) years of professional business, financial, and/or managerial work experience.
- Based on position requirements, additional education, training, and/or work experience in an area of specialization inherent to the position may be required.
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