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Revenue Cycle Manager

Summary

Reports directly to the Director of Revenue Services and responsible to develop plan, organize, manage and implement current and future strategies to bill customers, process payments, minimize bad debt, improve cash flow and manage the overall health of the company’s receivables. Also responsible for managing the day-to-day activities of the Peachtree Orthopedics and Peachtree Orthopaedic Surgery Centers as they relate to revenue cycle functions which include but are not limited to front office check-out services, billing, collections, accounts receivables and financial planning for patients and third party payors.

This position will work on revenue cycle performance to meet short term strategic goals and will provide analytical analysis and create written guidelines, policies, and procedures in accordance with implementation of all work processes as a result of thorough analysis.


Essential Duties and Responsibilities

General Management – 40%

  • Planning
    • Develops strategic plans and programs for the Revenue Cycle team and ensures that goals and objectives of the team are properly defined and clearly established.
    • Develops policies, guidelines, and implementing procedures and ensures consistent company-wide implementation.
    • Develops training plans, programs, and guidelines to ensure the team’s strict adherence with financial guidelines and requirements.
    • Ensures that operating expenses are well within the prescribed limits of budget plans and fiscal guidelines. Provides projections and reports as required, for development and management of department and staff performance; produce and analyze monthly reports that assist in the monthly and yearly employee performance reviews.
    • Monitors timeliness and effectiveness of department activities, ensuring that outstanding patient accounts and accounts receivables is no more than the agreed upon limit and that bad debt is within budgeted target.
    • Monitors effectiveness of collection efforts and maintains insurance billings are current within the established time frame specified in the department policy.
    • Compiles and prepares various status reports for management in order to analyze trends and make recommendations.
    • Enhance and standardize our work-flow processes throughout the revenue cycle to assist in achieving consistency in maintaining the critical success factors outlined in the Company’s standard operating procedures.
    • Create a cross functional training manual for revenue cycle staff and other departments that incorporates, as well as, aligns the company’s strategy and culture of Certainty and Operational excellence.
  • Organizing
    • Designs and develops the appropriate organization structure for the Revenue Cycle team.
    • Delineates, defines, and streamlines its various functional activities, thereby ensure its effectiveness in   maximizing the utilization of both asset and people resources.
  • Leading

    • Performs selection and staffing functions such as:

      • In collaboration with Human Resources Department, conducts in- depth assessment interviews to determine the technical and behavioral competencies of the candidate to ensure that the best from among the qualified candidates are being hired in the company.

      • Adheres to, and implements the philosophy of “hiring the best fit” and ensures that prospective employees’ personal values are aligned with the company’s corporate values.

    • Conducts regular and periodic meetings with the team, to ensure the following:

      • Implementation of all Revenue Cycle team plans, programs, and projects strictly adhering to prescribed deadlines and schedules.

      • All communications and relevant information pertaining to the team are cascaded to the proper channels within the team in particular, and the organization in general.

    • Conducts and implements “Performance Improvement Program”, through the following:

      • Performance coaching for the staff who failed to perform and deliver the prescribed and committed level of performance output and standards.

      • Performance counseling staff with behavioral/attitudinal problems. Implements the necessary guidelines on discipline management for erring employees, in accordance with company policies, rules and regulations, due process, and government regulations.

      • Performance mentoring for high potential staff, capable of assuming bigger responsibilities in the future.

    • Performs training and development functions, as follows:

      • Designs and develops training programs that are relevant and necessary for the continuous development of the technical competencies of the team.

      • Recommends and implements for appropriate training programs that will further enhance and hone the technical competencies of the staff.

      • Conducts training programs, and acts as subject matter expert on training programs pertaining to the Revenue Cycle team.

  • Controlling

    • Develops and formulates performance measures and standards for the team, as basis for the conduct of annual performance management review program.

    • Reviews and evaluates the performance of the team, on regular and periodic basis, and ensures that the overall performance of the team is on- track, and well within the pre-established goals and objectives.

    • Consolidates performance status reports of the team as basis for monitoring the weekly progress of the various activities within the team.

Patient Services Functions -60%

  • Manages and oversees the patient services and billing staff in handling patient relations.

  • Handles complex patients’ complaints and issues by explaining company policies and guidelines as well as those involving compliance issues with state and federal regulations.

  • Develops plans and programs in conjunction with SBU leaders to monitor patient relations thru the conduct of regular patient satisfaction surveys.

  • Records State and Federal Regulations Management

  • Ensures that HIPAA Notice of privacy Practices is on display, if applicable.

  • Ensures that patient financial and medical records are stored securely and handled in compliance with HIPAA privacy and security regulations, if applicable.

  • Implements state and federal regulations on clinic records management.

  • Arranges for HIPAA, OSHA and risk seminars in conjunction with Human Resources.

 

Education and/or Experience

  • Associate’s degree in health care administration, business or other related field, OR equivalent preferred.
  • Minimum of 1 year experience in health care management such as but not limited to clinic management, patient management, accounts receivables and payables, and marketing and public relations.
  • Strong background in financial management and knowledgeable of federal and state laws and requirements relating to healthcare management.
  • Strong managerial competencies in the areas of leadership and team development, managerial coaching and mentoring and situational assessment skills and with proven track record in building and developing high performing teams.
  • A change agent and capable of guiding the organization in initiating various change management initiatives with the view of leading and guiding the organization towards the future.
  • Strong ethics and a high level of personal and professional integrity.
  • Strong analytical skills and adept in interpreting strategic vision into an operational model.
  • An effective communicator at all levels in the organization, with strong oral, written and persuasive skills.

 

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