• Revenue Cycle Manager

    Job Locations US-MI-Petoskey
    ID
    2018-1057
    Category
    Accounting/Finance
    Type
    Regular Full-Time
  • Overview

    Position Summary

     

    The Revenue Cycle Manager is responsible for managing the daily operation of all MCDC billing functions including but not limited to: credentialing, insurance billing, patient billing, payment posting, refund processing, documentation and training, denial management, and accounts receivable management. This position works closely with Operations, Finance and IT to manage monthly revenue process, and to ensure revenue cycle integrity through regulatory compliance, proper reimbursement, and outstanding customer service.

    Responsibilities

    Typical Duties and Responsibilities

    • Organize and lead department to meet performance metrics for productivity & backlogs for charges, claims submissions, payments, refunds, denials, and AR follow up
    • Oversee organization credentialing process for all providers
    • Maintain fee schedule documents and all other master data tables
    • Work to integrate systems data to produce reports for operational, managerial, and executive leadership. Includes revenue, projected revenues, cash forecasts, denial metrics, etc.
    • Create and maintain process documentation to outline workflows, roles, and responsibilities required to carry out the goals of the team
    • Ensure consistent and actionable communication with clinical providers
    • Provide reporting and feedback to dental centers for correct coding and billing of patient accounts
    • Work proactively and closely with the compliance team on regulatory matters
    • Research reimbursement guideline/requirement changes, interpret updates, and coordinate subsequent reimbursement policy changes to assure compliance
    • Other duties as assigned

    Critical Skills

    • Leadership, including the ability to clearly communicate verbal or written expectations in a decentralized, multi-entity organization
    • Effectively adapt to and implement change
    • Ability to review, interpret and implement managed care contracts with third-parties, including governmental payers
    • Provide a high level of customer service to internal and external customers
    • Effective decision making skills that allow for logical, sound judgment
    • Ability to work independently and drive execution by understanding actions and performance necessary to motivate staff and provide an environment that strives for continuous improvement and increased efficiency
    • Foster a positive team work environment to include respectful, open communication and management practices while exercising confidentiality of sensitive subject matter at all times
    • Marshal resources to complete tasks and orchestrate multiple activities in a fast paced environment to accomplish goals and meet deadlines
    • Strong attention to detail, problem-solving, and critical thinking skills  

    Additional Knowledge, Skills and Abilities:

    • Personnel management:
      • Outline goals and objectives for all levels of staff within the team to achieve success
      • Conducts employee performance management duties including evaluations, setting goals, dissemination of information, coaching, and addressing performance issues
      • Manages payroll approval and time off for respective staff based on guidelines and exceptions

    Qualifications

    Education and Experience:

    • 8+ years’ experience in medical billing, with knowledge of current trends in Medicaid and commercial insurance
    • 5+ years’ experience in management
    • Bachelor’s degree from an accredited college or university in healthcare administration, business, accounting, or finance
    • Ideal candidate will have experience in a multi-entity organization in the health care industry
    • Familiarity with Electronic Health Records (EHR) systems is required; prior experience with Dentrix Dental Software preferred
    • Experience with clearinghouse software and oversight of claims submission processes required
    • Accomplished user in all Microsoft Office applications including Excel, Word, Outlook & PowerPoint
    • Dental experience preferred

     

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