Job Description:

ESSENTIAL JOB FUNCTIONS

Manages all business-related functions of revenue cycle, from client point-of-entry to accurate adjudication of client accounts, including charge processing, claim submission and processing, payment processing, collections and receivables management, denial management, reporting of results and analysis, concurrent and retrospective auditing, customer services relative to revenue cycle, training and development relative to revenue cycle, analytics, and all other revenue cycle management activities. Manages a team of A/R reps, billers, verification specialists, and cash posters, including hiring, training, evaluating, and developing staff members; conducting annual performance evaluations; and holding regular meetings to communicate about procedures, processes, and overall effectiveness.   Provides regular revenue-cycle status reports, including metrics and presentations, to upper management. Develops, monitors, and assesses business metrics in order to refine processes and improve performance, including collaborations with other departments to improve processes/operations, implement changes, and improve revenue workflow. Analyzes and corrects root causes of denials, billing errors, database errors, etc. that result in non-payment or denied claims. Monitors clearinghouse performance. Monitors and manages process of Fee for Service grant billing to ensure timely and accurate billing. Establishes relationship with key personnel at payer organizations, and resolving escalated reimbursement issues with payers. Monitors billing regulations and payer requirements for changes; communicates and coordinates implementation of billing regulation and payer requirement changes.

Reviews and reconciles A/R & allowance general ledger balance sheet accounts. Monitors adequacy of allowance account and corresponding allowance account methodology. Manages and monitors billed vs. approved rates. Develops, implements, and maintains revenue-cycle standard operating procedures. Follows all SCS policies and procedures. Completes all mandatory training within prescribed timeframes.

EDUCATION

• Bachelor’s Degree in accounting or business required
• MBA preferred. 

EXPERIENCE

• More than 8 years’ revenue-cycle experience in complex health care environment, preferably within comparable behavioral health or health and human services organization, including three-to-four years’ supervisory and/or management experience.   
• Proven grant management, billing, and accounting knowledge. 
• Management reporting and analysis. 
• Proven experience building teams and driving/implementing process improvement initiatives. 
• Excellent internal and external customer service skills. 
• Strong process and quality orientation. 
• Must possess excellent oral and written communication skills and recognize importance of teamwork. 
• Proficiency in Microsoft Office with advanced Excel skills.

PHYSICAL DEMANDS

• Position has no unusual physical demands. 
• May involve dealing with modestly unpleasant situations, including continual use of video display terminal.   

Time Type: