Job Description

Job Description

Job Description

Salary:

Position Summary:
The Revenue Cycle Manager role is an integral part of the success of Riverside Recovery of Tampa. This position is responsible for the overall management of the Behavioral Health billing process of medical claims to include ensuring appropriate contracts with insurance carriers are in place; managing the electronic billing software, timely invoicing and billing and collection for services provided. This position is also responsible for overseeing the work of the Billing and Coding Specialists and will provide support, direction, leadership, and coaching when needed.

Essential Duties and Responsibilities:
To perform this job successfully, an individual must be able to perform the following satisfactorily; other duties may be assigned. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Serves as the practice expert and go to person for all coding and billing processes
Maintain, negotiate, renew, and understand all insurance contracts
Oversees the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management
Understands and remains updated with current coding and billing regulations and compliance requirements
Participates in the development and implementation of operating policies and procedures
Create, implement, and audit billing procedures and processes
Facilitate departmental trainings to educate staff on all billable services to increase revenues
Perform chart audits to identify new billable services and missed billings
Analyze billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues
Analyzes trends impacting charges, coding, collection, and accounts receivable and take appropriate action to realign staff and revise policies and procedures
Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol, and are in compliance with Federal, State, and payer regulations, guidelines, and requirements
Maintains contacts with other departments to obtain and analyze additional patient information to document and process billings
Prepares and analyzes accounts receivable reports, and weekly and monthly financial reports in concert with the Controller. Collects and compiles accurate statistical reports.
Collaborate with other departments to get and analyze additional information about patients to be able to record and process billing effectively.
Follow up on claims using various systems, i.e., practice management and clearinghouse
Reviews and interprets operational data to assess need for procedural revisions and enhancements; participates in the design and implementation of specific systems to enhance revenue and operating efficiency
Maintains library of information/tools related to documentation guidelines and coding
Plans and directs patient insurance documentation, workload coding, billing and collections, and data processing to ensure accurate billing and efficient account collection
Keep up to date with carrier rule changes and distribute the information within the practice
Supervises billing office personnel, which includes work allocation, training, and being available for staff needs; motivates employees to achieve peak productivity and performance
Provides, oversees, and/or coordinates the provision of training for new and existing billing staff on applicable operating policies, protocols, systems and procedures, standards, and techniques
Coordinates team member time off in a manner that does not negatively impact necessary daily functions
Respond to inquiries from insurance carriers, via telephone, email or fax and demonstrate a high level of customer service
Advise management of any trends regarding insurance denials in an effort to identify problems with particular payers
Monitors claims for missing information and authorization/control numbers
Completes work within authorized time to assure compliance with departmental standards
Assists billing staff with coding issues or questions
Demonstrates support of the mission, vision, value statements, standards, policies and procedures, operating instructions, confidentiality standards, and the code of ethical behavior
Accountable for being knowledgeable and understanding of all aspects of the billing and coding staff duties to include:
o Billing of accurate clean claims by attaching necessary documentation for payment charges according to insurance payors/contracts
o Follow-up on electronic claims and paper claims
o Posting insurance payments to patient accounts
o Submit all secondary claims when necessary
o Refund money owed to patient or insurances
o Other duties as assigned by the Controller

Required Qualifications:
High School diploma or GED
One year of prior experience in billing of third-party insurances for facility and professional. services required (medical, mental health or substance abuse industry).
Knowledge of third-party billing requirements.
Proficiency with utilizing EMR and multiple billing platforms.
Strong knowledge of all laws and regulations that governing billing and coding.
In-depth understanding of Net Patient Service Revenue and Patient Accounts Receivable
Preferred Qualifications:
Five (5) years of experience conducting in-house billing and coding within the medical, substance abuse or mental health industry.
Certified Professional Coder (CPC), Certified Professional Biller (CPB) or equivalent.

Full time Benefits:

• 401-K match
• Health Insurance
  
• Dental
• Vision
• Life Insurance
• Disability
• Critical Illness
• Hospital Indemnity/Accident plan
• Legal plan

Employer Paid Benefits:

$10,000 life insurance

$10,000 Short term Disability

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