Manager of Revenue Cycle by qingyunliuliu


									Laser Spine Institute Job Description
Position Title: Manager of Revenue Cycle               Dept Name: 760 Corporate Patient Financial
Reports To: Director of Patient Financial Services
Supervises: Revenue Cycle Specialists

   Position Summary: This position is responsible for managing the functional operations of collection and
A/R management to include policy and procedure development, internal and external communications,
statistical reporting, trend analysis, and issue resolution for all medical offices and facilities.


       Manage the processing of all personnel actions; performs performance evaluations; and initiates
        corrective-action plans when appropriate, including reporting results of follow-up audits.
       Establish, record in writing and implement appropriate billing policy procedures, and procedures for
        all billing activities. Develops, maintains and distributes Revenue Cycle Scorecard which reports
        strategic revenue cycle indicators.
       Maintains a thorough understanding of managed care contracts and coordinates contract
        implementation issues.
       Identify, plan, and manage revenue cycle projects designed to reduce A/R, improve operational
        efficiency, and/or increase cash flow.
       Implements efficiencies within admissions (verifications, pre-certs; etc.) to ensure expedient and
        accurate completion of responsibilities.
       Maintains and reconciles payment activity from lockbox, providing clear and concise reporting, and
        scheduling meetings for follow up or training when needed.
       Coordinates and follows-up on all pre-certification and insurance verification denials.
       Monitors all aspects of the aging of accounts receivable. Identifies and implements improvements
        to maximize financial gain, and streamline operational steps necessary to improve financial trends.
       Identifies, reports and resolves issues that will result in accurate and timely payment of accounts.
       Implements efficiencies within claims resolution department to ensure expedient and efficient
        resolution of outstanding claims.
       Develop QA programs to ensure appropriate management of patient accounts within areas of
       Creates standardized and timely reporting for Administration to report on the performance of the
        section. Makes use of trend analysis, and benchmarking to support decision-making.
       Develops strategies to reduce denials in conjunction with the applicable resources within the

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                  Identifies and suggests enhancements to the billing system.
                  Notifies payers of AR issues, providing clear and concise documentation when necessary,
                   providing quantitative data, and scheduling meetings for follow up or training when needed.
                  Coordinates and follows-up on all insurance appeals.
                  Researches, analyzes, and takes appropriate corrective action with patients, payers, outside
                   collection agencies, and staff to support maximum effectiveness and efficiencies of revenue cycle.
                  Provides guidance and feedback to end-uers about denials, appeals, their outcomes, and
                   managed care contractual requirements.
                  Must identify specifics and trends of denials and denial write offs.
                  Other duties as assigned.

            Education: Required: BA/BS Degree or four years related supervisory experience required.

           License/certification: Required: none

           Experience & Skills: Required: A minimum of 5 years of healthcare management experience in any or all
           of the following; Revenue Cycle; Patient Financial Services; CBO; Managed Care; Consulting & A/R.
           Familiar with billing concepts, practices, and procedures. Proven record managing people, building teams.

                                        Essential Physical and Mental Requirements

                                                        Continuous           Frequent          Occasional               Rarely
Physical Demands
                                                         Over 70%           40%-69%             15%-39%            Up to 15%
Standing                                                                                                                  X
Walking                                                                                                                   X
Climbing                                                                                                                  X
Bending                                                                                                                   X
Crouching                                                                                                                 X
Pushing/Pulling                                                                                                           X
Carrying                                                                                                                  X
Lifting/Lowering                         1-15 lbs.                                                                        X
                                        15-30 lbs.                                                                        X
                                        30-50 lbs.                                                                        X
                                       Over 50 lbs.                                                                       X
Fine Hand/Eye Coordination                                                                                                X
Color Discrimination                                                                                                      X
Hearing Acuity                                                                                                            X

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                                                    Continuous        Frequent         Occasional         Rarely
Mental Demands
                                                    Over 70%          40%-69%           15%-39%         Up to 15%
Concentration on Detail                                 X
Attention Span of 1+ hours on a task                    X
Ability to Remember multiple tasks                      X
Oral Communication                                      X
Written Communication                                   X

                                                    Continuous        Frequent         Occasional         Rarely
Working Conditions
                                                    Over 70%          40%-69%           15%-39%         Up to 15%
Exposure to blood and body fluids                                                                             X
Exposure to toxins, cytotoxins, poisons                                                                       X
Exposure to extreme heat, cold, temp fluctuations                                                             X
Exposure to hazardous chemicals                                                                               X
Exposure to radiation                                                                                         X

Date Issued:                                                Department Review: David Neal, Dir PFS
Date Revised: August 2010                                   Human Resources Review: Kellie Brady, TAP
Employee Signature:                                         Date:

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