Revenue Cycle Manager Job Description

Job summary 1

The Revenue Cycle Manager drives the daily operational activities for end-to-end revenue cycle performance on behalf of our clients. Direct accountability includes working with both internal and external customers to create efficient process workflows with production teams, developing account resolution strategies, and monitoring key performance indicators to deliver targeted performance outcomes.

Duties & Responsibilities 1

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Requirements & Skills 1

Job summary 2

We are seeking a Revenue Cycle Manager who will work closely with the VP of Revenue Cycle and the senior management team and will be involved in all aspects of the revenue cycle process for each location. This includes developing and implementing strategies, processes, and technologies to continuously improve and manage the revenue cycle process in a fast-paced, high-volume, multi-site healthcare setting.

Duties & Responsibilities 2

Requirements & Skills 2

Job summary 3

We are seeking a Revenue Cycle Manager responsible for participation in and oversight of functions within the Revenue Cycle. As a critical team member, the Revenue Cycle Manager will work with various stakeholders. The team member will provide hands-on leadership to ensure the successful execution of processes across the Company's revenue cycle. In addition, the Revenue Cycle Manager will work closely with operations and clinical leaders and their staff to identify issues and opportunities with payers, systems, and process trends or patterns that impact the company's overall efficiency and profitability.

Duties & Responsibilities 3

Requirements & Skills 3

Job summary 4

The Revenue Cycle Manager manages all insurance billing, follow-up, payer enrollment, and no-response activities and is responsible for the performance and effectiveness of the department. The Manager will be responsible for implementing short and long-term plans and objectives to improve revenue and reduce denials. Additionally, they will be responsible for working with insurance companies to identify reasons for delayed payment for services and additional information requests. The Manager will work to identify and correct denial trends related to follow-up activities. They will empower staff to develop methods of process improvement, including planning, setting priorities, conducting, systematic performance assessments, implementing improvements based on those assessments, and maintaining achieved improvements.

Duties & Responsibilities 4

Requirements & Skills 4

Job summary 5

The Revenue Cycle Manager is responsible for managing the Revenue Cycle Outsourcing business including financial outcomes (e.g., operating income/expense controls), customer satisfaction, and employee satisfaction as per individual contracts. This also includes Business Office/Patient Access/Physician Office functions which encompass all functions of First/Third Party Claims Operations, manage registration, admitting, insurance verification, customer service, and managed care contracts. Oversee performance and contract compliance. Facilitate problem resolution between hospital and/or physician departments and the Business Office.

Duties & Responsibilities 5

Requirements & Skills 5

Job summary 6

The Revenue Cycle Manager provides leadership and is responsible for the management of the Patient Financial Services, oversees scheduling, patient access, billing, insurance follow-up, denials management, cashiering, refunds, customer service, self-pay collections, bad debt, charity care, chart assembly, and chart maintenance; responsible for maintaining the integrity of billing and collection.

Duties & Responsibilities 6

Requirements & Skills 6

Job summary 7

The Revenue Cycle Manager is responsible for the day-to-day operations related to all revenue cycle functions with a focus on customer service, quality improvement, and stewardship.

Duties & Responsibilities 7

Requirements & Skills 7

Job summary 8

The Revenue Cycle Manager will develop, plan, organize, and implement revenue cycle strategies to bill customers, process payments and improve cash flow. The position will provide leadership, guidance, and mentorship to a team of billing professionals.

Duties & Responsibilities 8

Requirements & Skills 8

Job summary 9

The Revenue Cycle Manager is responsible for supervising and coordinating aspects of the revenue cycle including training, internal auditing, billing, claims production, collections, productivity, performance reporting, and new ASC transitions.

Duties & Responsibilities 9

Requirements & Skills 9

Job summary 10

Under the general direction of the Chief Financial Officer, the Revenue Cycle Manager coordinates the activities of the Business Office, including billing, cash posting, correspondence, and claims follow-up. The Revenue Cycle Manager will create, maintain and administer training and professional development programs to increase staff knowledge and skills.

Duties & Responsibilities 10

Requirements & Skills 10

Frequently asked questions

What is the role of a revenue cycle manager?

The role of a Revenue Cycle Manager is to oversee and manage the financial processes and operations related to the revenue cycle of a healthcare organization. The revenue cycle encompasses the entire process of generating revenue, from patient registration and billing to payment collection and financial reporting. Here are the key responsibilities and functions of a Revenue Cycle Manager:

Financial Process Management: The Revenue Cycle Manager is responsible for managing and optimizing the financial processes within the revenue cycle, including patient registration, insurance verification, charge capture, coding, billing, and collections. They ensure that these processes are efficient, accurate, and comply with relevant regulations and industry standards.

Revenue Optimization: The Revenue Cycle Manager focuses on maximizing revenue for the organization by ensuring accurate and timely billing and collection of payments. They identify opportunities to improve revenue capture, reduce denials, and minimize payment delays. They may implement strategies to enhance reimbursement rates, negotiate contracts with payers, and develop pricing models.

Staff Supervision and Training: The Revenue Cycle Manager oversees a team of staff involved in revenue cycle operations, such as billing specialists, coders, and collections staff. They provide guidance, training, and performance management to ensure that the team operates effectively and efficiently. They may also recruit and hire qualified staff as needed.

Compliance and Regulatory Management: The Revenue Cycle Manager ensures compliance with applicable healthcare regulations, billing guidelines, and coding standards. They stay updated on changes in regulations and implement processes to address compliance requirements. They may also oversee audits and internal controls to mitigate risks and maintain compliance.

Technology and Systems: The Revenue Cycle Manager evaluates, selects, and implements revenue cycle management systems and technologies to optimize efficiency and accuracy. They work with IT teams to integrate systems, enhance automation, and improve reporting capabilities. They may also provide training and support to staff in using these systems effectively.

Financial Reporting and Analysis: The Revenue Cycle Manager generates and analyzes financial reports related to the revenue cycle. They track key performance indicators (KPIs), such as revenue, denials, collection rates, and days in accounts receivable. They identify trends, variances, and areas for improvement, and provide insights and recommendations to senior management.

Collaborative Relationships: The Revenue Cycle Manager collaborates with various stakeholders, including clinical departments, finance, compliance, and IT teams. They work closely with clinical staff to ensure accurate charge capture and documentation. They also collaborate with payers, patients, and external vendors to resolve billing and payment-related issues.

Continuous Process Improvement: The Revenue Cycle Manager continuously evaluates and improves revenue cycle processes to enhance efficiency, accuracy, and financial performance. They may lead or participate in process improvement initiatives, such as streamlining workflows, implementing best practices, and utilizing data analytics to identify improvement opportunities.

The role of a Revenue Cycle Manager is critical in maintaining the financial health of a healthcare organization. By optimizing revenue cycle operations, ensuring compliance, and implementing effective processes and technologies, they contribute to the organization's financial stability and success.

What makes a good revenue cycle manager?

A good Revenue Cycle Manager possesses a combination of skills, qualities, and expertise that enable them to effectively manage the financial operations of the revenue cycle in a healthcare organization. Here are some key attributes that make a good Revenue Cycle Manager:

Strong Financial and Revenue Cycle Knowledge: A good Revenue Cycle Manager has a deep understanding of financial management principles and practices specific to the healthcare industry. They are well-versed in revenue cycle operations, billing, coding, reimbursement methodologies, and healthcare regulations. This knowledge allows them to make informed decisions, address challenges, and optimize revenue generation.

Analytical and Problem-Solving Skills: A good Revenue Cycle Manager is adept at analyzing financial data, identifying trends, and solving complex problems. They can interpret financial reports, track key performance indicators (KPIs), and use data analytics to make data-driven decisions. They proactively identify bottlenecks, inefficiencies, and areas for improvement in the revenue cycle and implement strategies to overcome them.

Leadership and Team Management: A good Revenue Cycle Manager is an effective leader who can motivate and inspire their team. They provide clear direction, set performance expectations, and foster a positive and collaborative work environment. They possess strong interpersonal and communication skills to effectively manage and communicate with team members, stakeholders, and external partners.

Knowledge of Healthcare Regulations and Compliance: A good Revenue Cycle Manager stays updated on healthcare regulations, such as HIPAA, billing guidelines, and coding standards. They ensure compliance with these regulations and guidelines within the revenue cycle operations. They understand the importance of maintaining data privacy and security and enforce appropriate measures to protect sensitive information.

Technology and Systems Proficiency: A good Revenue Cycle Manager is well-versed in revenue cycle management software and technology systems. They have experience in selecting, implementing, and optimizing revenue cycle management systems and electronic health record (EHR) systems. They continuously evaluate technological advancements and leverage them to enhance efficiency, accuracy, and reporting capabilities within the revenue cycle.

Customer Service Orientation: A good Revenue Cycle Manager understands the importance of providing excellent customer service to patients, insurance companies, and internal stakeholders. They ensure that billing and payment processes are handled with empathy, transparency, and professionalism. They proactively address customer concerns and inquiries, striving to deliver a positive patient financial experience.

Continuous Learning and Adaptability: A good Revenue Cycle Manager embraces a mindset of continuous learning and growth. They stay updated on industry trends, regulatory changes, and best practices in revenue cycle management. They adapt to evolving industry dynamics, technological advancements, and changing reimbursement models. They seek opportunities for professional development and actively participate in relevant workshops, conferences, and networking events.

Strategic Thinking and Results-Driven Approach: A good Revenue Cycle Manager has a strategic mindset and a focus on achieving results. They set measurable goals and develop strategies to optimize revenue, reduce denials, improve collections, and streamline processes. They collaborate with cross-functional teams and senior management to align revenue cycle goals with organizational objectives.

By embodying these skills and qualities, a good Revenue Cycle Manager can effectively lead and manage the financial operations of the revenue cycle, ensuring revenue optimization, compliance, and financial stability for the healthcare organization.

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