Revenue Cycle Manager

GENERAL DESCRIPTION: The Revenue Cycle Manager provides support and training to the Revenue Cycle Supervisor to ensure accuracy of all medical claims prior to billing, follow up on unpaid claims, correct denied claims, post 835s to patient accounts. This position is responsible for ensuring that all OASIS assessments are reviewed and diagnosis coded prior to final clinical review. Oversees the billing side of Finance including supervision of associates.

DUTIES AND RESPONSIBILITIES

• Act as a liaison between Oasis/Coding Contractor and clinicians.
• Ensure that all Oasis are reviewed and submitted on a timely basis.
• Understand and maintain knowledge of current regulatory coding.
• Keep Chief Financial and Compliance Officer informed of outstanding issues.
• Maintain current knowledge to assess accurate and timely billing and rebilling of claims for all payers.
• Assist with accounts receivable (A/R) processes including patient accounts and collections.
• Provide support and training to Revenue Cycle Specialist in all areas of billing and accounts receivable processes, including assisting with denials and unpaid claims.
• Manage billing/financial components of agency software including all payers, payer-specific formatting, clinical service codes, pricing, contractual rates, etc.
• Recruit, interview, hire, orient and supervise Revenue Cyle Supervisor or other assigned associated
• Oversee billing and payment functions of Finance Department.
• Manage agency supply process.

Other Duties

• Maintain skills through attendance at Annual Skills Fair or other continuing education opportunities.
• Participate in special projects and perform other duties as requested.
• Keep a daily record of time worked per agency policies.

Compliance

• Participate in quality improvement (QI) activities to positively impact performance on agency's overall outcomes.

Confidentiality

• Assure all staff/patient information is kept confidential.
• Dispose of all written information, with the exception of the employee's personnel file and the patient's chart properly when no longer needed.
• Information about the patient/client, their condition, and their care will not be discussed with other patient/clients, the public or with other VNA staff in public places. Discussions should be respectful and related to direct patient care.

Staff Participation

• Attend and take part in staff/team meetings and applicable in-services. Complete required in-service hours in a timely manner.
• Follow team decisions in achieving agency objectives.
• Foster atmosphere of teamwork and pride in providing agency services.

Work Environment

• Keep work environment clean and orderly and in a sanitary condition.
• Keep storage areas free from accumulation of material that constitutes hazards.
• Present a professional personal appearance in accordance with established agency dress code; wear name badge.

Infection Control

• Observe and follow all agency and regulatory guidelines for infection control in accordance with established policies and procedures.

QUALIFICATIONS:

Education, knowledge, licensure and certification

• Graduation from high school or completion of GED required.
• Associate degree, equivalent from two-year college or two-year related experience preferred.
• Certification in Professional Coding (CPC) or equivalent required within 6 months of employment.
• Association of Home Care Coders certified (HCS-D) within one year of employment required.

Experience

• Basic level knowledge of EMR (electronic medical records), Microsoft operating system and Microsoft Word, Excel and Outlook.
• Training and experience with billing and accounts receivable experience and other related functions.
• Knowledge of medical terminology.

Behavior standards

• Strong communication and interpersonal skills that allow staff to foster relationships, build rapport and establish patient trust to produce positive patient outcomes and work environment for both internal and external customers.
• Initiative to make independent decisions within scope of practice, licensure and/or policies and procedures of the agency.
• Function as a member of an interdisciplinary health care team, committed to the team approach for patient care.
• Represent the agency with honesty, integrity, loyalty, strong work habits and a professional demeanor.
• Communicate effectively with patient/clients, families, physicians, health care providers and other community agencies.
• Respond appropriately in stressful situations.