Revenue Cycle Manager, AR & Analysis at Complete Health Partners, INC

Location: 3500 Blue Lake Drive Birmingham, AL 35243 OR 339 Walker Chapel Rd Suite 115 Fultondale, AL 35068

Schedule: Monday-Friday 8am-5pm

Pay Range: $80,000-90,000 per year, dependent on experience 

The Revenue Cycle Manager AR and Analysis manages, coordinates, and oversees overall daily operations of Complete Health physician practices to ensure maximization of cashflow while improving patient, physician, stakeholder and other customer relations. Responsibilities include stewardship of Patient Billing and Collection, A/R Management, Application Systems Support, Claims Management, Coding, Charge Capture, Data Entry, Account Follow-Up, Customer Service, Denial Management, Edit Management, Payment Variance Analysis, Contract Analysis, Credit Analysis, Refund Management, Payment Posting, Auditing, Training, and Productivity and Performance Reports.

The Manager provides oversight and support for Group Practice Revenue Cycle integrity and workflow processes. Assures all established billing systems, and workflow process requirements have been met in order to ensure timely and optimal reimbursement. The Manager recommends changes that will positively impact the Revenue Cycle and help the Central Business Office operate according to industry benchmarks and meet A/R performance goals and productivity.

ESSENTIAL JOB FUNCTIONS:

• Manages the operational performance and overall management of the Central Business Office (CBO) AR and Analysis staff by performing all necessary functions to support Revenue Cycle goals and align to industry benchmarks.
• Ensures activities of CBO billing operations are conducted in a manner that is consistent with overall department billing protocols, and are in compliance with Federal, State, and payer regulations, guidelines, and requirements. Implements and monitors adherence to the organization's billing, collection, and refund policies and procedures.
• Reviews, and assesses Revenue Cycle AR activities and functions by interpreting operational data to assess need for procedural revisions and enhancements; participates in the design and implementation of specific systems to enhance revenue and operating efficiency.
• Assists in leading monthly Department Administrator and Operations meetings, Revenue Cycle meetings, as appropriate to provide data and feedback on Revenue Cycle AR operations management. Prepares regular and ad-hoc reports and presentations to support meeting agendas.
• Responsible for leading AR staff to maintain Revenue Net Collection Rate and AR goals and benchmarks.
• Assist the accounting department with revenue recognition by ensuring the data (insurance packages, pro fees, ancillaries, etc.) from the billing system(s) are mapped, organized and exported correctly for accurate revenue reporting in the Company's financial statements.
• Oversee the patient refund process including automation and payment of refunds.
• Oversee the accounting and reconciliation processes inside of EMR for unapplied cash, unpotable and any other clearing accounts inside of the billing system(s)
• Assist the manage care and accounting department in developing best practices to ensure risk insurance capitation is working properly in the billing system(s)
• Analyzing revenue cycle data, preparing revenue forecasts, and performing trend analysis.
• Promotes effective communications between Central Business Office AR personnel, Front-End staff, and Department Administrators to ensure ongoing education/training and expedite problem resolution.
• Supports company, group, and department financial analysis. Provides feedback and works directly with Clinic sites with support from practice managers and Market Directors to develop and implement action plans for improving operations and business-related functions impacting billing and reimbursement needed to identify and manage challenging Revenue Cycle processes and problem payors.
• Assists and participates in creation of training manuals and job aids for respective area(s) of expertise and responsibility.

• Supports and manages existing capabilities related to the standardization and consolidation of daily/weekly/monthly reporting revenue cycle reporting

• In conjunction with the Revenue Cycle Director Supports Complete Health's growth efforts, clinical initiatives, and development of new markets by assuring provider and system setups and tablespace expectations are delivered timely.