Revenue Cycle Manager - Medical / Behavioral Health

Choptank Community Health System’s mission is to provide access to exceptional, comprehensive and integrated health care for all. Our Vision is to improve the health and well-being of the communities we serve; to provide an outstanding care experience; and to be an exceptional place to work and make a difference.

Job Summary: The Medical and Behavioral Health Revenue Cycle Manager is primarily responsible for timely submission of medical and behavioral health claims to insurance companies. This position will support the six health centers within Choptank Community Health System (CCHS) and the School Based Health Centers (SBHC). The responsibilities include supervising support staff with processing claims, posting of charges and payments when needed, follow-up of accounts, answering of patient calls and staff from the outlining centers and management. Serves as the system resource on medical and behavioral health billing requirements and workflows. This position will involve additional responsibilities as performance demonstrates capacity.

Required Skills/Abilities:

• Must be able to work independently and have excellent problem-solving skills to be able to judge urgency of need for accurate results.
• Familiar with data entry and Practice Management Systems.
• Must have working knowledge of medical terminology and word usage to ensure accurate appointment scheduling and concise, detailed oriented performance to ensure optimum referral tracking and follow-up.
• Highly organized and self-motivated
• Ability to work with others in a team base setting.
• Must possess valid drivers’ license and have dependable transportation.

Education and Experience:

• Bachelor’s degree preferred.
• Prior management experience in revenue cycle for a medical office, preferably in an FQHC environment.
• Computer skills in Microsoft Office Suite, Athena experience a plus.
• Knowledge of CPT & ICD-10 coding required.

Core Values:

• Commitment To Service
• Respect
• Quality
• Teamwork
• Patient Focus
• Integrity
• Accountability
• Caring & Compassion
• Professionalism
• Listening & Responding
• Safety
• AIDET

Job Related Competencies:

• Attention to Detail- The ability to process detailed information effectively and consistently.
• Problem Solving- Identifies and analyzes problems weighing the relevance and accuracy of available information. Generates and evaluates alternative solutions and makes effective and timely decisions.
• Communicates Effectively- Developing and delivering multi-mode communication that convey a clear understanding of the unique needs of different audiences.
• Values And Ethics- Serving with integrity and respect in personal and organizational practices. Ensuring decisions and transactions are transparent and fair.
• Time Management- The ability to effectively manage one’s time and resources to ensure that work is completed efficiently.

Duties/Responsibilities:

• Prepares and analyzes accounts receivable reports, monthly financial reports. Collects and compiles accurate statistical reports.
• Keep up to date with carrier rule changes and distribute the information within the practice.
• Follows on unpaid claims within standard billing cycle timeframe.
• Maintains contacts with site leadership to obtain and analyze additional patient information to document and process claims.
• Assist with identifying opportunities to educate site staff to increase efficiency and timeliness of claims processing.
• Checking each insurance setup and payments for accuracy and compliance with contract discount.
• Ensures that the billing operations are conducted in a manner that is consistent with department protocol, and follow Federal, State, and payer regulations, guidelines, and requirements.
• Works with finance director during the month-end close process to ensure reports are accurate and timely.
• Oversees the operations of the medical and behavioral health billing staff, encompassing coding, charge entry, claims submissions, accounts receivable follow-up, and reimbursement management.
• Identify trends impacting charges, coding, collection, and accounts receivable and take appropriate action to educate or realign staff, as necessary.
• Researching and appealing denied claims.
• Meets deadlines as assigned.
• Regular, reliable attendance is a requirement of this job.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

COVID-19 considerations:
Note: As a healthcare organization that accepts Medicare/Medicaid - we are required to comply with all Federal mandates related to vaccines. This requirement applies to all current and future Choptank employees.