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Revenue Cycle Manager

Company: Brown & Toland Physicians
Location: Riverside
Posted on: May 11, 2022

Job Description:

The Reve nue Cycle Manager , at the direction of the Altais Director of Corporate Accounting , is accountable for all aspects of the revenue cycle for Altais Medical Group-Riverside (AMGR) , located in Riverside, CA. A ccountabilities include but are not limited to: coding, claim submission, denial management, payment posting, managing credit balances, addressing patient inquiries , making collection decisions and eventually hiring billing team members as the medical group grows . This role will ensure all aspects of the revenue cycle are efficient, processed timely to m eet f iling guidelines and meets or exceeds industry standard performance benchmarks . The Revenue Manager must exhibit a positive demeanor, excellent verbal and written communication skills, effective training and collaboration skills and be professional in both appearance and approach. Essential Functions: The essential functions listed are typical examples of work performed by positions in this job classification. They are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Employees may also perform other duties as assigned. Employees must abide by all Altais guidelines including but not limited to sensitivity to cultural diversity, patient care, patient's rights and ethical treatment, safety and security of physical environments, emergency management, teamwork, respect for others, participation in ongoing education and training, communication and adherence to safety and quality programs, sustaining compliance and licensure and health screenings. Essential functions:

  • Manage s all billing/coding processes and ensures clean claims are submitted timely.
  • Provides on-going coding and compliance review of provider charges, identif ies and address es compliance issues or areas of potential payment denial.
  • Builds a coding and documentation program to include regular review of coding and documentation with the physicians of AMGR, providing training aids and making the program collaborative with a high degree of professionalism and customer service
  • Approaches the revenue cycle with a continuous improvement and learning mindset, working closely with the front desk and other clinic colleagues to reduce billing errors, maximize timely cashflow and limit patient complaints
  • Provides leadership and serves as the subject matter expert for all revenue cycle related technology i mplementations .
  • Supports and collaborates with other teams, ( ie IS, Finance, Quality , Operations) for electronic medical record (EMR) configuration requirements and other systems that impact the revenue cycle ; oversees EMR and practice go-live support for revenue cycle workstreams
  • Participates in the acquisition and onboarding of new physicians into AMGR ensuring credentialing is complete, EMR configured , coding/documentation program in place and at-the-elbow support provided as needed.
  • Routinely reports on revenue cycle performance indicators (KPIs), interfaces w/physician leadership and Altais leadership on current performance and areas of improvement
  • Coordinates provider payor enrollment w ith Altais MSO , including Medi-Care/Medicaid applications for timely activation of payor contracts ; maintains relationships with 3 rd party vendors for system set-ups ( Instamed , Change Healthcare)
  • Drafts and executes revenue cycle policies and procedures , ( ie cash pay/prompt pay , non-covered services /pro-bono patients) insuring all components of the policy approval process are met prior to policy implementation
  • Responsible for annual CPT and ICD-10 provider and staff coding education and updates. Stays up to date on all payor, MAC and fiscal intermediar y program guidance, makes recommendations for system (EPIC) change orders /optimizations
  • Works in coordination with practice on the patient complaint process by identifying problems and coordinating appropriate corrective action and/or service recovery ; responds to patient feedback through direct correspondence while maintaining program integrity and reputation of the Altais brand . Seeks the advice of Altais legal counsel or Risk Management when appropriate Minimum Qualifications: Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying. --- 5 years of physician business office management/billing experience required --- Bachelors Degree preferred or an equivalent combination of education and experience

Keywords: Brown & Toland Physicians, Riverside , Revenue Cycle Manager, Executive , Riverside, California

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