Manager Revenue Cycle

Job Description

Manager Revenue Cycle

Location: Denver Colorado

Pay rate: $37.08 - $54.47

Shift: Monday through Friday

Responsible for overall monitoring and analysis of the organization's revenue, ensuring accuracy and compliance of revenue cycle processes. Identify and resolve issues that could lead to denials.

Preparing, monitoring, and reconciling reimbursement reports, proactively working with payors to identify and resolve claim denials, and assuring payor contract compliance is paramount to our success.

Role Specific

Review encounters for unsigned charts and lack of charges, including impacts

Review encounters with Non-Billable and LOS not needed Codes/Charges

Serves as a subject matter expert across the organization to mitigate losses from denials.

Review and educate on front end denials - registration, coding, authorization, etc.

Collections - front desk copay collection and past due balance opportunities

Physician productivity - analyzing where there are opportunities with provider schedules, RVUs, etc.

Provides crucial support and training across business units to ensure teams are well versed in revenue cycle processes.

Ensures optimal performance in all areas of denial prevention in compliance with policy and regulatory requirements.

Leads and drive denials prevention projects through collaboration with leadership.

Implements strategies to enhance the efficiency and accuracy of revenue cycle operations.

Analyzes data to identify trends, areas of system and process improvement, and opportunities for optimization.

Performs root cause analysis, then prepare and implement action plans.

Denial Rate: Track and analyze the percentage of denied claims to identify patterns and root causes, enabling targeted improvements in documentation and coding processes.

Clean Claim Rate: Measure the percentage of claims submitted without errors to ensure faster approvals and reduce the need for costly rework.

Days in Accounts Receivable (A/R): Monitor the average time it takes to collect payments to improve cash flow and financial predictability.

Insurance AR over 90 days %: Identifies the percentage of open insurance AR over 90 days to further understand why payment has not been collected.

Net Collection Rate: Assess the actual revenue collected against the expected revenue to ensure optimal financial performance and identify opportunities for growth

Other Duties as assigned

Qualifications

Required:

High school diploma or GED equivalent

Three years' experience in Revenue Cycle medical claims management

Analytical skills and the ability to interpret data to drive informed decisions.

Attention to detail with an ability to maintain a high level of accuracy.

Preferred:

Bachelor's degree in finance, Business or related field from an accredited university. Education is verified.

Epic systems experience

Five (5) years of experience in medical billing/claims follow up

Experience and understanding of Microsoft Office

Full-time