North Mississippi Health Services
Revenue Cycle Manager
North Mississippi Health Services, Winfield, Alabama, United States, 35594
Overview
JOB SUMMARY The Revenue Cycle Manager at North Mississippi Health Services is responsible for supervising the daily activities of the Insurance Billing & Collections Department, overseeing collections, and ensuring the accurate and timely processing of accounts. As a manager of people, this role is responsible for supervising a team and optimizing operations within a designated department or area, ensuring productivity and effective team management. Responsibilities
Supervise : Plans, directs, and coordinates the daily activities of the Insurance Billing & Collections Department. Manage, oversee, and evaluate the Payment/Recon Specialist, Credit Resolution Analyst, Customer Service Representative to ensure maximum collection of all receivable/miscellaneous revenue. Conducts annual performance evaluations and provides feedback. Interviews, hires, trains, and provides corrective action (when necessary). Collections : Ensure accurate and timely collection of all appropriate revenue. Ensure effective financial management of Accounts Receivable. Ensure timely and accurate processing of accounts in accordance with best practices, defined workflow, procedures, and applicable legislature/regulations. Directs the training of employees to include orientation, continuous training in areas such as commercial insurance requirements, UCR Requirements, Medicare and Medicaid remote processes, compliance, etc. to increase productivity and efficiency of Insurance Department. Oversees the billing system including maintenance and adherence to insurance regulations in terms of edit, physician and facility tablets, all code tablets, and reimbursement issues. Monitors daily deposit of payments taken in at Business Services. Monitor payment denials and notifies appropriate department to obtain correct information or initiate an appeal. Works with department heads on coding and billing issues and processes. Informs departments of denials regularly so that preventative action can be taken. Directs the insurance and patient correspondence unit, works with Billing, Collections, Nursing, Utilization Review, etc., and monitors activity so that problem areas can be addressed promptly. Communicates regularly with departments on late charges, incorrect charges and other matters that impact Business Services’ ability to process claims and resolve patient accounts. Oversees the insurance claims conflict system, compliance and insurance requirements to prevent false claims submission and ensure compliance with Medicare and other payer regulations. Customer Service : Creates strong customer service orientation and collaboration. Provide excellent customer service to all internal and external customers. Communication : Effectively communicates information to staff, internal and external customers. Liaison : Serves as a liaison between Manager and collection team. Budget : Comply with departmental budget guidelines. Reporting : Monitors and measures collection performance against cash performance. Ensures appropriate financial reporting. Responsible for analyzing, verifying, collecting, and resolving outstanding balances on accounts. Regulation : Adheres to NMHS/NMMC Policies/Procedures/Guidelines. Complies with applicable Local/State/Federal policies/procedures/guideline/regulations/laws/statues. Qualifications
The following qualifications describe the required and preferred criteria for this role. Education Bachelor's Degree in Business, Coding or equivalent field — Required Or Associate's Degree — Willing to consider 4 yrs Claims, Billing/Follow-Up, or revenue cycle experience beyond minimum requirement in lieu of Bachelor degree — Required Or High School Diploma or GED Equivalent — Willing to consider 8 yrs Claims, Billing/Follow-Up, or revenue cycle experience beyond minimum requirement in lieu of Bachelor degree — Required Licenses and Certifications Licenses and Certifications Details — Time Frame — Required/Preferred Work Experience 4-6 years Claims, Billing/Follow-Up, or revenue cycle experience — Required 4-6 years Experience/knowledge of managed care reimbursement methodology including ICD-10, CPT-4 and/or HCPCS and DRGs — Required 4-6 years Experience in Leadership and Team Management: Experience successfully leading a team and fostering a collaborative and efficient work environment — Required Knowledge, Skills and Abilities Knowledge of collection techniques and laws — Required Knowledge of insurance reimbursement methodologies and coding requirements — Required Knowledge of governmental payer and insurance rules and regulation — Required Working knowledge of Account Receivable systems, Medicare/Medicaid/3rd Party billing requirements and reimbursement methodology — Required Proficient in Microsoft Office (Word, Excel, and Outlook) — Required Knowledge of applicable state and federal regulations relating to billing and collections — Required Excellent negotiating and analytical skills — Required Strong verbal and written communication skills — Required Excellent interpersonal skills — Required Effectively and efficiently prioritize and organize tasks — Required Provides supervision to direct reports — Required Develops, implements/evaluates projects (timely & efficient manner) — Required Evaluates and provides coaching for all employees within the scope of responsibility — Required Ensures accurate and timely collection of all appropriate revenue — Required Ensures effective financial management of Accounts Receivable — Required Ensures timely and accurate processing of accounts in accordance with best practices, defined workflow, procedures, and applicable legislature/regulations — Required Gathers and relays information with knowledge, tact, and diplomacy — Required Must have daily contact with co-workers, patients, 3rd Party payors, and other NMHS/NMMC staff members — Required Must reflect a positive, caring attitude toward clients, patients, staff and the public we serve — Required Evaluates and coaches reporting employees towards accomplishing major goals and objectives — Required Scope Freedom To Act Problem Solving Impact Financial Responsibility Sales Revenue Target Responsibility Approval Responsibility P & L Responsibility Assets Controlled Controllable Expenses (e.g., Payroll and other budgeted items) Total Financial Responsibility: Budget Responsibility Primary Budget Responsibility Shared Budget Responsibility
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JOB SUMMARY The Revenue Cycle Manager at North Mississippi Health Services is responsible for supervising the daily activities of the Insurance Billing & Collections Department, overseeing collections, and ensuring the accurate and timely processing of accounts. As a manager of people, this role is responsible for supervising a team and optimizing operations within a designated department or area, ensuring productivity and effective team management. Responsibilities
Supervise : Plans, directs, and coordinates the daily activities of the Insurance Billing & Collections Department. Manage, oversee, and evaluate the Payment/Recon Specialist, Credit Resolution Analyst, Customer Service Representative to ensure maximum collection of all receivable/miscellaneous revenue. Conducts annual performance evaluations and provides feedback. Interviews, hires, trains, and provides corrective action (when necessary). Collections : Ensure accurate and timely collection of all appropriate revenue. Ensure effective financial management of Accounts Receivable. Ensure timely and accurate processing of accounts in accordance with best practices, defined workflow, procedures, and applicable legislature/regulations. Directs the training of employees to include orientation, continuous training in areas such as commercial insurance requirements, UCR Requirements, Medicare and Medicaid remote processes, compliance, etc. to increase productivity and efficiency of Insurance Department. Oversees the billing system including maintenance and adherence to insurance regulations in terms of edit, physician and facility tablets, all code tablets, and reimbursement issues. Monitors daily deposit of payments taken in at Business Services. Monitor payment denials and notifies appropriate department to obtain correct information or initiate an appeal. Works with department heads on coding and billing issues and processes. Informs departments of denials regularly so that preventative action can be taken. Directs the insurance and patient correspondence unit, works with Billing, Collections, Nursing, Utilization Review, etc., and monitors activity so that problem areas can be addressed promptly. Communicates regularly with departments on late charges, incorrect charges and other matters that impact Business Services’ ability to process claims and resolve patient accounts. Oversees the insurance claims conflict system, compliance and insurance requirements to prevent false claims submission and ensure compliance with Medicare and other payer regulations. Customer Service : Creates strong customer service orientation and collaboration. Provide excellent customer service to all internal and external customers. Communication : Effectively communicates information to staff, internal and external customers. Liaison : Serves as a liaison between Manager and collection team. Budget : Comply with departmental budget guidelines. Reporting : Monitors and measures collection performance against cash performance. Ensures appropriate financial reporting. Responsible for analyzing, verifying, collecting, and resolving outstanding balances on accounts. Regulation : Adheres to NMHS/NMMC Policies/Procedures/Guidelines. Complies with applicable Local/State/Federal policies/procedures/guideline/regulations/laws/statues. Qualifications
The following qualifications describe the required and preferred criteria for this role. Education Bachelor's Degree in Business, Coding or equivalent field — Required Or Associate's Degree — Willing to consider 4 yrs Claims, Billing/Follow-Up, or revenue cycle experience beyond minimum requirement in lieu of Bachelor degree — Required Or High School Diploma or GED Equivalent — Willing to consider 8 yrs Claims, Billing/Follow-Up, or revenue cycle experience beyond minimum requirement in lieu of Bachelor degree — Required Licenses and Certifications Licenses and Certifications Details — Time Frame — Required/Preferred Work Experience 4-6 years Claims, Billing/Follow-Up, or revenue cycle experience — Required 4-6 years Experience/knowledge of managed care reimbursement methodology including ICD-10, CPT-4 and/or HCPCS and DRGs — Required 4-6 years Experience in Leadership and Team Management: Experience successfully leading a team and fostering a collaborative and efficient work environment — Required Knowledge, Skills and Abilities Knowledge of collection techniques and laws — Required Knowledge of insurance reimbursement methodologies and coding requirements — Required Knowledge of governmental payer and insurance rules and regulation — Required Working knowledge of Account Receivable systems, Medicare/Medicaid/3rd Party billing requirements and reimbursement methodology — Required Proficient in Microsoft Office (Word, Excel, and Outlook) — Required Knowledge of applicable state and federal regulations relating to billing and collections — Required Excellent negotiating and analytical skills — Required Strong verbal and written communication skills — Required Excellent interpersonal skills — Required Effectively and efficiently prioritize and organize tasks — Required Provides supervision to direct reports — Required Develops, implements/evaluates projects (timely & efficient manner) — Required Evaluates and provides coaching for all employees within the scope of responsibility — Required Ensures accurate and timely collection of all appropriate revenue — Required Ensures effective financial management of Accounts Receivable — Required Ensures timely and accurate processing of accounts in accordance with best practices, defined workflow, procedures, and applicable legislature/regulations — Required Gathers and relays information with knowledge, tact, and diplomacy — Required Must have daily contact with co-workers, patients, 3rd Party payors, and other NMHS/NMMC staff members — Required Must reflect a positive, caring attitude toward clients, patients, staff and the public we serve — Required Evaluates and coaches reporting employees towards accomplishing major goals and objectives — Required Scope Freedom To Act Problem Solving Impact Financial Responsibility Sales Revenue Target Responsibility Approval Responsibility P & L Responsibility Assets Controlled Controllable Expenses (e.g., Payroll and other budgeted items) Total Financial Responsibility: Budget Responsibility Primary Budget Responsibility Shared Budget Responsibility
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