Revenue Cycle Manager

APPLY HERE!


GENERAL RESPONSIBILITIES: 

The Revenue Cycle Manager at Whitney Young Health (WYH) manages the functions of the organization’s billing and revenue cycle to maximize cash flow while maintaining and improving internal and external customer relations. The Revenue Cycle Manager will contribute to the day-to-day operations on all issues related to the revenue cycle function, provide analysis, create written processes and train others in the organization on the revenue cycle process.


SPECIFIC RESPONSIBILITIES:

  • Revenue Cycle Manager acts as the primary resource over the medical coding function; reviews the work of other medical coding and clinical staff to ensure compliance with the departmental policies and other applicable laws and regulations; identifies and documents patterns of improper coding and suggest solutions. 
  • Educates providers to improve accuracy of chart coding; advising them on proper code selection, required documentation, procedures, and other requirements; identifies performance issues and works with the Director of Revenue Cycle to address and rectify these issues.
  • Responsible for the evaluation and coding of the medical records to optimize reimbursement, and ensure legal compliance and accuracy in billing and medical documentation for private and government programs
  • Responsible for payer coding policies and procedures to ensure that the department remains in compliance with specific claims submission rules in order to reduce denied claims. 
  • Identifies areas that would permit enhanced reimbursement and reduce denials of claims
  • Develops a strong working relationship with the payers to understand payer requirements, resolve problems and investigate new services.
  • Responsible for verification of correct claims payments in accordance with contracts with payers.
  • Revenue Cycle Manager plays a key role in the implementation of the new Electronic Medical Record and provide agency wide training on the new EMR.
  • Collaborates with practice managers to develop and monitor procedures to ensure accurate input and collection of patient information, and to maximize individual and third party reimbursement, and identify and reduce errors
  • Maintains education on coding requirements for ICD-9 and 10, CPT, HCPCS, ADA, and FQHC specific coding rules, including revenue and rate codes
  • Ensures that CPT/diagnoses/ADA codes are up to date and reflect changes in WYH programs
  • Maintains a working knowledge of New York State Marketplace and enrollment requirements
  • Ensures Certified Application Counselors (CAC) outreach to patients and community groups to provide enrollment services as required by BPHC
  • Serves as the backup to the Director of Revenue Cycle in the credentialing process of providers with all payers
  • Assists with audits by independent auditors, state insurance examiners and insurance plan representatives
  • Demonstrates excellence in both internal and external customer service.
  • Understands and is able to effectively communicate HIPAA compliance, corporate compliance and client confidentiality.
  • Ensures and/or remains in compliance with local, state, and federal regulation, i.e. DHHS HRSA and NYSDOH, and all accreditation standards (e.g. Joint Commission and NCQA-PCMH).
  • Adheres to the National Patient Safety Goals as defined by the Joint Commission and Whitney M. Young Jr. Health Center.
  • Completes other duties as assigned.

MINIMUM QUALIFICATIONS:

Associates Degree; three (3) to five (5) years relevant experience may be substituted in lieu of a degree. At least 7 years of progressively responsible experience in patient account billing and collections in a complex outpatient setting with automated systems. Certification from the AAPC as a Certified Professional Claims Coder. Prior experience reviewing and coding from medical record, including Behavioral Health, Addictions, and Ob/Gyn. Prior supervisory experience


PREFERRED QUALIFICATIONS:

Bachelors Degree in a business discipline.

 

Please be aware that as a facility regulated under Article 28 of the New York State Public Health Law, COVID-19 vaccination is a requirement of employment. Whitney Young Health also requires the COVID-19 booster.


All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other legally protected status.


APPLY HERE!

Powered By GrowthZone