PLANNED PARENTHOOD SOUTHWEST OHIO REGION JOB DESCRIPTION POSITION: Revenue Cycle Manager DEPARTMENT: Finance
REPORTS TO: CFO STATUS: Exempt (Full-time)
UPDATED: October 2024
JOB SUMMARY: The Revenue Cycle Manager will provide leadership, oversight, evaluation and direction for the revenue cycle for Planned Parenthood of Southwest Ohio to achieve revenue goals. Provides analytic support and operational leadership to ensure sustainable growth of client base, market share and revenue in a manner that is consistent with the Agency's overall missions, goals and objectives. Leads revenue cycle, billing functionality, technology, and service components determined by strategic and departmental work plan goals. Collaborate with Patient Services and the Contact Center to optimize billing/accounts receivable functionality and supports coding and billing activities at the health centers.
RESPONSIBILITIES: 1. Develop and maintain revenue cycle policies and procedures to ensure that the Agency is maximizing billing and collections, minimizing adjustments and write-offs, denials management, and appeals processing, while remaining in compliance with federal/state and HIPAA privacy and security regulations and the terms of our payer contracts and other federal/state programs.
2. Provide visionary and strategic leadership to guide billing practices and operations, as well as the ability to perform daily duties and responsibilities.
3. Lead the revenue cycle area of the agency-wide compliance program. This includes but is not limited to: participating in the internal/external audit process, designing action plans, recommending and/or implementing process improvements.
4. Collaborate with Patient Services leadership by providing CPT coding guidance.
5. Collaborate with Patient Services leadership, Training, Center Managers, Patient Access and Contact Center Staff to develop and implement procedures on front-end processes such as data collection, point of service patient collections, pre-authorization, eligibility and insurance verification.
6. In conjunction with the managers of the clinics, develop and maintain policy, procedures, and workflow processes to facilitate access to care while balancing financial sustainability of the Agency.
7. Analyze data requirements of Finance, Patient Services and Senior Management and create and produce a range of reports to address these needs, including rejection reports, error reports, accounts receivable reports, denial reports, revenue forecasts and ad hoc reports as well as a variety of "real time" reports as requested.
8. Develop and report on benchmarks and key indicators of revenue cycle functions to be reported on a daily, weekly and monthly basis.
9. Develop financial analyses of contracts and potential contracts in terms of cost of care delivery and actual or proposed reimbursement rates.
10. Support contract financial administration by developing training materials for clinical management, clinical front-desk personnel and billing staff in collaboration with the Patient Services leadership.
11. Prompt response to questions from agency staff and the third-party billing partner, related to Revenue Cycle management and questions.
12. Analyze accounts receivable data (such as days outstanding in accounts receivable, percent of accounts over 90 days old, bad debt percentages etc.), extract it into meaningful presentations and communicate the results as well as identify problem sources and develop an action plan for continuous improvement.
13. Participates in the development of the annual operating budget.
14. Performs other duties as assigned by supervisor.
KNOWLEDGE AND SKILL REQUIREMENTS: · Bachelor's in Business, Finance, Accounting, Health Management or related field or equivalent experience.
· Seven years' experience managing medical billing, and knowledge of the healthcare industry including insurance contracts, billing and collections.
· Experience with EPIC, the EMR (Electronic Medical Records) and EHR (Electronic Health Records) system, preferred.
· Ability to communicate effectively with patients, staff and co-workers of diverse backgrounds in a non-judgmental manner.
· Ability to communicate effectively with all levels of staff, Board members, peers and other key stakeholders.
Strong analytical and problem-solving skills.
Ability to set priorities and organize a variety of concurrent projects, manage time effectively, and follow through reliably.
· Must have excellent computer skills with knowledge of Microsoft Word, Excel, Outlook, and the Internet.
· Must have the willingness and ability to adapt to change including advances in technology.
· Must have excellent customer service and be committed to providing the highest level of customer satisfaction.
· Commitment to the highest level of integrity and customer service.
Commitment to the mission of Planned Parenthood
· Ability to function well as a team member
· Commitment to PPSWO's mission, goals and objectives.
PHYSICAL REQUIREMENTS/WORKING CONDITIONS: Able to lift and/or move up to 25 pounds, sit, talk, hear, stand, bend, walk; use hands and fingers, handle or operate objects, reach with hands and arms; climb and balance; stoop, kneel, crouch, crawl. and use repetitive motions of the hands and wrists.
· Ability to get to the work site and other PPSWO health centers and meetings when required.
\n RequirementsHepatitis B and MMR Immunization recordsCOVID Vaccine CardFlu VaccinationReferences( 3: former supervisors and colleagues) Benefits Voted top place to work Supportive team environment Growth opportunities 11 Paid holidays a year Matching 401k Health care plan Extensive training program
\n55k -75k annually