Revenue Cycle Manager

Website Columbia Orthopaedic Group

Columbia Orthopaedic Group

This position, reports to the CEO and is part of the Management Team.   The primary focus of this position is to manage and oversee all functions of the Revenue Cycle process.   This includes coding, eligibility, prior-authorization, EDI/claim submission/claims rejects, charge entry, payment posting, patient account representatives, A/R follow up, patient statements, and external collections activities.   Responsibilities include, but are not limited to the following:

Works with the CEO to develop and implement the revenue cycle strategy and process.

Plans, develops, and implements programs, projects, strategies, processes, and technology to continuously improve and manage the revenue cycle and increase profitability.

Collects, organizes, analyzes, and disseminates information from various data sources with attention to detail and accuracy, including timeliness.

Reports on daily operational statistics as requested by leadership, key findings, insights and recommendations to respective counterparts.

Analyzes data for insights into claims management, and for special prevention and denials management projects. This includes identifying denial trends by root cause, payer-related issues, physician trends, etc.

Motivates and leads high-performing teams; attracts, recruits and retains required members as needed. Hires and trains all revenue cycle personnel in coordinating with subordinate supervisors.

Develops staff that can analyze and recommend ongoing improvements to processes, procedures, systems and reports

Works closely with other members of the management team to achieve the business objectives and goals identified by the Executive Committee and COG Partners.

Analyzes and resolves problems that affect the revenue cycle, both inside and outside of the Business Office.

Acts as a liaison to clinical and non-clinical departments to ensure that new initiatives and contracts are accurately implemented, monitored and followed

Develops and maintains appropriate internal controls in the Business Office and Coding departments.

 

Requirements

A successful candidate for this position will reflect the following work experience, training and abilities:

5-7 years successful Healthcare Revenue Cycle Management experience overseeing a healthcare revenue cycle and managing associated staff.

Excellent relationship building skills and aptitude for working collaboratively with cross-functional groups.

Demonstrated success in directing and leading others.

An effective communicator with strong oral and written skills.

Strong analytical and problem-solving skills to identify trends and issues, and the ability to execute solutions to address issues.

Intermediate to advanced experience in Microsoft Office products with a strong emphasis in Excel.

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