Revenue Cycle Manager in Scott Depot, West Virginia at FamilyCare Health Centers

Physical Requirements:

• Must be able to frequently stand, walk, sit, stoop, and reach
• Must be able to frequently utilize typing skills
• Prolonged periods of sitting working on a computer
• Specific vision abilities required, which include: distance vision, color vision, depth perception and ability to adjust focus
• Must be able to on occasion lift and/or move up to 25 pounds

Qualifications:

• High School diploma required
• College degree preferred; or an additional 3 years relevant work experience
• 5+ years of experience in medical billing, collection and credentialing processes
• 5+ years of leadership experience
• Proficient in medical billing, coding and credentialing; AAPC or AHIMA certification preferred
• Understanding and execution of CPT and ICD-10 coding
• Outstanding verbal and written communication skills
• Ability to identify, diagnose and resolve billing issues affecting business performance
• Previous FQHC revenue cycle experience preferred

Basic Functions:

The Revenue Cycle Manager is responsible for the supervision and coordination of billing and collection associates. Provides oversight for credentialing of all providers and site locations. Performs billing and collection duties in accordance with FamilyCare Health Centers policies and procedures.

Duties and Responsibilities:

• Oversees the operations of the billing department, credentialing department, encompassing coding, charge entry, claims submission, payment posting, accounts receivable follow-up and reimbursement management
• Responsible for conducting annual billing and coding external and internal audit including follow-up education
• Ensures that the activities of the billing department are conducted in a manner that is consistent with overall department protocols, and are in compliance with Federal, State, and payer regulations, guidelines, and requirements.
• Evaluates, implements and works with EHR vendors to assure billing system is operational
• Provides written correspondence to billing associates of insurance payer changes
• Generates annual fee schedules/sliding fee documents for approval and input into EHR
• Confirms and generates all refunds to accounting monthly
• Updates written policies and procedures for billing and credentialing
• Administrates and keeps up with training of Direct Data Entry (DDE) System – Medicare
• Oversees unpostable and zero pays monthly
• Provides coding feedback to providers, clinical department leadership and revenue cycle team
• Generates reports and/or analyzing data related to evaluation and management code utilization, CPT code application, denials, and/or reimbursement per contracted terms, etc.
• Provides revenue cycle team support with coding related denials
• Oversee and complete provider/site credentialing
• Other duties as assigned