Kenosha Community Health Center is looking for an experienced Revenue Cycle Manager to support it's many clinics.
Maximize reimbursement for patient services through effective management and utilization of processes and information flow throughout the revenue cycle.
ESSENTIAL FUNCTIONS/KEY COMPETENCIES
· Manage and direct Revenue Cycle functions for all patient revenue streams including insurance reimbursement, collections and patient payments.
· Knowledge of healthcare billing laws, medical terminology/abbreviations and established professional billing processes, procedures and protocols.
· Experience with CPT-4, ICD-9, HIPAA, and CHR implementation, full revenue cycle of the organization including coding, billing, charge entry, adjustments, and reimbursements, Medicaid PPS, Medicare, and Sliding Fee programs.
· Expertise in practice management systems including functionality and reporting, quality review and continuous quality improvement in policies and procedures.
· Establish, record, and implement appropriate billing policy procedures for all billing activities, including follow-up on third party approvals and collection of over-due patient accounts.
· Establish and maintain cooperative and effective working relationships with others; use discretion in handling difficult situations and/or persons; communicate clearly and concisely, both verbally and in writing.
· Evaluate key revenue strategies and services, and identify opportunities for improvement. Perform quarterly audits to prevent internal control weaknesses and to ensure an independent and objective evaluation of the operation.
· Oversee procedures between clinics and business office staff to resolve issues and outstanding problems in the area of A/R management and Revenue Cycle process.
· Excellent organizational and analytical skills; work independently with minimal direction.
· Collaborate with billing and operational staff to identify and analyze reasons for claim rejections in order to develop, implement and monitor improvement initiatives throughout the revenue cycle to reduce rejections.
· Develop relationships with major payers’ key staff in order to effectively troubleshoot delinquent claims and reduce claim rejections.
· Develop and maintain key performance indicators (KPI) and implement mechanisms to monitor performance in order to achieve continuous quality improvement.
· Collaborate with billing and operational staff to develop and maintain cycle policies and procedures including workflow processes. Assist in providing training and guidance to ensure adherence to said policies and procedures.
· Recommend enhancements to improve practice management systems.
· Ensure that reimbursement complies with contractual terms and conditions of each major payer.
· Coordinate internal audits to reduce errors in coding, documentation, registration, data processing and refunds.
· Maintain fee schedules to ensure that patient charges maximize contractual reimbursement, cover costs, keep pace with market, and minimize economic barriers to underserved patients.
· Bachelors’ Degree, or equivalent, in business administration, healthcare administration or a related field. Master’s Degree preferred.
· 5-7 years in a healthcare setting as a revenue cycle professional.
· 4 years minimum management or supervisory experience.
· Applicable revenue cycle, coding, and/or healthcare administration license or certification preferred but not required.
· FQHC or non-profit healthcare experience preferred, but not required.
WHAT WE OFFER
As a full time employee, you will receive an impressive portfolio of benefits designed to help you maintain a comfortable lifestyle for you and your family, including Major Medical, Dental, Vision, Flexible Spending Account, Short-term Disability, Long-term Disability, 403(B), Life Insurance, Paid Vacation and Holidays.
Kenosha Community Health Center is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability or veteran status.