Revenue Cycle Manager - TRH

Responsible for overall functions of the Business office, supervising staff, monitoring productivity and reports to insure timely and accurate reimbursement.

Job Duties:

Provides oversight and accountability to the Business Office, Registration, Data Processing, Financial Counseling, Denials Management and Precertification department.

Assists the Revenue Cycle Director

Reviews electronic claims workflow for current and pending claims

Reviews denial management for discrepancies and inefficiencies

Monitors reports for accuracy and timeliness of billed claims and follow-up

Monitors and reviews patient outstanding balances, collections and bad-debts

Reviews remittance advices; determines problems causing rejections and denials

Ensures that the pre-cert department is obtaining prior authorizations or approvals in a timely manner

Communicates with third party payers in regards to claims processing difficulties or new processing procedures

Maintains extensive knowledge of revenue cycle and regulatory requirements associated with governmental, managed care, and commercial payers.

Maintains an effective and efficient workload for each hospital biller

Education:

High School Diploma or Equivalent

Bachelor’s Degree in related field is preferred – experience in lieu of education may be substituted

Training/Experience:

2 years supervisory experiences required

3 years Billing/AR – Denial Management with hospital and/or professional claims which demonstrates attainment of the required requisite job knowledge and abilities.

Skills/Qualifications:

Proficient in Microsoft Office products, specifically Excel

Proven leadership skills and ability to gain cooperation and support from a diverse body of individuals

Highly dependable in both production and attendance

Ability to effectively prioritize and execute tasks while under pressure; make decisions based on available information and within the scope of authority of the position; excellent customer service skills, including professional telephone interactions.

Exceptional organization, problem solving, and time management skills with an attention to detail

Excellent verbal and written business communication skills sufficient to clearly document issues and effectively communicate.

Promote the mission, vision, and values of Taylor Regional Hospital.

Maintain confidentiality of all patient, medical, financial, and legal information.

Represent the organization in a positive amp; professional manner.

Ability to handle difficult situations involving patients, physicians, staff and others in a positive and professional manner.

Comply with all organization policies and standards

Consistently demonstrate the value of team concept.

Understands and abides by OSHA, HIPAA and CLIA standards

Understanding of HIPAA regulations and proven ability to ensure confidentiality with respect to sensitive information