Revenue Cycle Manager

Management Escondido, California


Requisition ID
34111
Department
Administration
Location
Escondido, California
Union
Not Applicable
Job Type
Full-Time
Shift
Day
Hours Per Shift
8
Hours Per Pay Period
80

Description
Responsible for the provision of the direction and supervision of Palomar Health Medical Group revenue cycle functions, ensuring a strategy and vision for these services that support the medical group strategic plan. Accountabilities include coordination and implementation of , patient financial services, Provider payer credentialing and enrollment, revenue integrity analytics, denials management and revenue cycle vendor management. Responsible for development and updating of contractual reimbursement and bad debt projections including contract change impact modeling. Monitors actual to projected reimbursement addressing variances in timely manner. Working collaboratively with physician leadership and operations f to ensure continuous improvement of physician documentation and identify opportunities for improvement in denials. Responsible for working with coding / clinical documentation, , operations, patient registration and patient financial services to identify and resolve issues which impact denials. Worksclosely with coding, utilization management and operations to identify and improve processes impacting denials and lost revenue. Monitors changes in health plan and regulatory requirements and facilitates communication and process modifications throughout the organization including those in support of the organizations delegated health plan designation. Develop, implement, and administer standardized and best practice revenue cycle management policies, procedures and automation facilitating both proficiency and high productivity. Working collaboratively information technology (IT) to ensure revenue cycle systems integration and data accuracy. Responsible for tracking / reporting monthly revenue cycle key performance indicators (KPIs), developing targeted improvement workplans to address negative variances. Practices excellent employee relations and attention to employee needs. Develops and mentors a high performing team for all areas of responsibility. Ensures financial viability by managing both applicable revenue and expenses with attention to third-party and supply cost utilization and a high level of productivity in cost centers under direct control.

Speak and read English at a level that is sufficient to satisfactorily perform the essential functions of the position. Knowledge of standard office equipment (i.e., calculator, fax, photocopier) and personal computer and computer software skills (i.e., MS Windows, Excel, Access, Word, Powerpoint, internet, e-mail). Windows computer skills including proficient use of keyboarding, use of mouse or keys for functions such as selecting items, use of drop down menus, scroll bars, opening folders, copying and similar operations required upon employment or within the 1st two weeks of employment to perform the essential functions of the job. Performs other duties as assigned. Follows Palomar Health rules, policies, procedures, applicable laws and standards. Carries out the mission, vision, and quality commitment of Palomar Health.

Job Requirements

Minimum Education: Associates Degree (AA) or equivalent experience
Preferred Education: : Bachelor's degree (BA/BS) with emphasis in Business or Healthcare Management
Minimum Experience: Minimum of five to seven years business office experience with three to five years of Supervisor experience in a healthcare setting or combination of education and experience
Preferred Experience: Billing workflow certification for Nextgen or comparable practice management system.
Required Certification: Not Applicable
Preferred Certification: Not Applicable
Required License: Valid Driver's License
Preferred License: Not Applicable

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We are an equal opportunity employer and do not discriminate against applicants or employees based on race, color, gender, religion, creed, national origin, ancestry, age, disability, sexual orientation, marital status or any other characteristic protected by law.