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    Revenue Cycle Manager - Sacramento, United States - Sacramento Native American Health Center

    Sacramento Native American Health Center
    Sacramento Native American Health Center Sacramento, United States

    6 days ago

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    Description

    Here at SNAHC, you are joining a team and company at a time of growth and transformation. You will love being surrounded by people who are as passionate as you are about healthcare and giving back to the community. Please note that individual total compensation for this position will be determined at the Company's sole discretion and the wage range for this role considers a wide range of factors including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. At SNAHC, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $72,564-$98,175.

    Position Summary:

    The Revenue Cycle Manager, reporting directly to the Director of Finance, is an integral part of the Federally Qualified Health Center patient and family centered health care organization. They manage all revenue cycle operations.This position manages and oversees policies, objectives, and initiatives to optimize patient financial interactions and optimize cash flow in accordance with contracts and regulations.They ensure compliance with all regulations, policies and procedures related to medical billing for facility charges and physician services.They supervise and oversee a team of professionals in duties pertaining to the organization's revenue cycle operations which includes, but is not limited to, monitoring and enforcing contracted third-party billing workflows, providing education and training to staff involved in the revenue cycle, leading the achievement and maintenance of department goals.

    Essential Functions:

    • Serves as a subject matter expert in FQHC billing, coding, and reimbursement, staying abreast of FQHC industry updates, requirement modifications and best practices.
    • Supervises the billing/coding support team, performing management duties including recruiting, onboarding, timekeeping, performance evaluations, coaching and progressive discipline as needed, using SNAHC prescribed best practices.
    • Facilitates communication and collaboration with third-party Revenue Cycle Management (RCM) partners and vendors, as well as commercial and Geographic Managed- Care (GMC) payers.
    • Work with Finance Department to book, post, or otherwise resolve incoming payments for services rendered and to process patient refunds in a timely manner.
    • Manages accounts receivable by monitoring the gaining payment reports monthly to identify trends and underpayments; investigate causes and take appropriate steps toward resolution using professional judgement.
    • Performs regular audits of daily billing reports to identify coding and billing errors. Working closely with the Billing Specialists, notifying on-site management of problems and troubleshoot as needed.
    • Provides technical expertise to ensure accurate billing including billing for new services and staying informed of regulatory, compliance, and best practices for FQHC billing.
    • Performs overall revenue cycle management including but not limited to: satisfying timely filing requirements and maximizing billing revenue and collections, and oversight and resolution of denied/ rejected claims.
    • Support various teams (clinical providers, development professionals, etc.) in Health Center with information on fundamentals of and/or periodic changes in coding or documentation requirements.
    • Ongoing oversight of contracted rates/ fees, capitated patient revenue, and annual maintenance of internal Usual, Customary and Reasonable (UCR) fee tables.
    • Monitors and improves any trends resulting in claim rejections or denials.
    • Coordinates internal service teams, working with partners to reduce recurring errors, identify needs for resources changes, etc. Ensure alignment of internal messaging and deliverables with other service teams.
    • Supports pre-implementation consideration and development of new lines of business.
    • Complies with all state and federal laws and regulations, as they pertain to the position including HIPAA, sexual harassment, Scope of Practice, OSHA, SCAR reporting, etc.
    • Leads in internal quality improvement teams.Works with team members proactively to drive quality improvement initiatives in accordance with the mission and strategic goals for the organization, federal and state laws and regulations, and accreditation standards.
    • At all times demonstrates cooperative behavior with supervisors, subordinates, colleagues, clients and the community.
    • Maintains a high level of discretion and confidentiality of sensitive materials and issues.
    • Other duties as assigned.
    Competencies:
    • Planning and Organization
    • Communication and Relationships
    • Team building
    • Staff Supervision and Development
    • Excellent verbal and written communication skills
    • Strong organizational, problem-solving, and analytical skills
    • Strong Electronic Health Record and computer skills
    Minimum Qualifications:
    • Working knowledge of CPT, HCPCS, and ICD10
    • Demonstrated proficiency in the use of computers with electronic billing practice software such as NextGen Management Software and EPM. Working knowledge of Medical Billing Systems/Electronic Health Records.
    • Minimum 4 years' experience in healthcare revenue cycle and/or billing, to include CPT, ICD-10 coding and modifiers with medical, dental and mental health.
    • At least two years of supervision experience preferred or a proven record of supervising a team to achieve results or evidence of strong leadership skills with the ability to guide, direct, train and interact with staff and clients.
    Preferred Qualifications
    • Certified Professional Coder Certification.
    • Comprehensive knowledge of billing procedures for payers within Federally Qualified Health Centers setting in California.
    • Experience working with all types of third-party payers (Medi-Cal, Medicare, managed-care, and commercial payers)
    • Experience implementing process updates in response to environmental changes.
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