Revenue Cycle Manager Collections

Qualifications

• Associate's or Bachelor's degree preferred.
• Minimum of 8+ years of experience in Billing Management, Revenue Cycle, and/or Finance, including hospital billing.
• Knowledge of the insurance reimbursement process for both in-network and out-of-network claims.
• NSA/IDR/TDI, third-party negotiations experience.
• Understanding of medical ICD-10 codes, CPT, DRG codes, and Revenue codes.
• Knowledge and understanding of Insurance Explanation of Benefits.
• Able to work with minimal direction and oversight.
• Self-starter who can work well independently or as part of the team.
• Ability to effectively prioritize and manage multiple daily/weekly/monthly tasks.
• Have the capacity to relate to people in a manner to win confidence and establish rapport.

Job Responsibilities/Duties

• Coordinate efforts of your assigned Collections team, independently and as a team with other Managers and leadership to achieve collection and other goals set for the department.
• Be personally responsible for the success and/or failures of your team but also empower the Medical Collections team to take the same responsibility.
• Monitor Collections follow-up activity and hold team members accountable to establish targets and thresholds.
• Direct work efforts of all team members.
• Provide assistance in the transition and management of all tasks allocated to the back office and resolve any issues affecting Collections.
• General Collections management and upstream reporting on the health of A/R.
• Meet defined goals for production, quality, and overall performance.
• Develop reporting to proactively monitor A/R to identify and resolve issues affecting collections. Track, identify, and resolve barriers to ensure timely and accurate processing of all facility and physician claims.
• Coordinate with Coding, Payment Posting, and Patient Collections as necessary to ensure any barriers are resolved or assistance provided as necessary.
• Monitor, understand, and communicate to the Director of Operations trends by payer, facility, and year, including but not limited to: Production, Denials, No activity, Collection Rate, Overturned claims.
• Analyze trends impacting collections and take appropriate action to realign the team and revise policies.
• Audit each team member to ensure that all proper workflows and follow-up are being adhered to and update as necessary. Any areas of improvement will be identified immediately and addressed with the team member.
• Review and update medical record documentation as necessary to aid in collections workflow. Provide detailed reports to senior leadership to outline and address any areas of improvement needed to aid in timely collection of A/R.
• Supervise Collections personnel, which includes work allocation, training, and problem resolution.
• Provide, oversee, and/or coordinate the provision of training for new and existing collection team members.
• Keeps updated on all collection and insurance benefit changes for insurance carriers.
• Maintains strict confidentiality; adheres to all HIPAA guidelines/regulations.
• Meets the performance goals established for the position in the areas of: efficiency, accuracy, quality, member satisfaction and attendance.
• Perform other miscellaneous job-related duties as assigned.