REVENUE CYCLE MANAGER-MSH-78319-003

Reporting to the Faculty Practice Administrative Director, the Revenue Cycle Manager is responsible for the Icahn Mount Sinai School of Medicine’s Elmhurst and Queens, Faculty Practice Groups revenue cycle business needs and mission. The Revenue Cycle Manager will oversee the Article 28 multi-specialty physician group.  Responsibilities include but are not limited to, establishing and maintaining procedures to maximize charge capture, billing, accounts receivable follow up, resolution of edits and claim denials all within the constraints of payor timely filling guidelines. Serves as liaison between external third-party business relationships to maintain the Faculty Practice Groups (FPG) best interest.

Monitor and evaluate external billing vendor performance using KPI’s. Track Days in Accounts Receivable, Net Collection Rate, clean claim rates, and denial rates. 

Audit vendor submitted claims and payment postings. Offer denial management workflows to guarantee accuracy and minimize revenue loss.

Work closely with the billing vendor to create and analyze all areas of the revenue cycle to help improve processes and maximize collections.  Identify areas for improvement in Accounts Receivable management. Review any claim rejections and/or denials to ensure timely payment of claims.

Meet with Directors of Service and their physicians, along with the billing vendor, to discuss all key performance indicators for their department. 

Work with managers and coding staff to ensure prioritizing daily workflow to ensure the timely submission of claims. Follow up with and billing vendor to identify the outliers and make sure they are processed for billing. 

Standardize customer service functions. Evaluate front end edits to provide feedback to facility administration such as registration and pre-authorization workflows.

Manage and troubleshoot provider enrollment and credentialing workflows to prevent impact on claim submission and timeliness.

Work with the vendor and management team for special claims projects, by creating reports for submission based on the payors required templets. 

Work with the FPG staff and billing vendor to quickly identify and correct any edits generated from the billing platform, coding staff, clearinghouse or Accounts Receivable team. 

Assist patients with any professional billing issues and resolve complaints as necessary.

Keeps abreast of state and federal regulations governing reimbursement of all physician services. Maintains the privacy and confidentiality of patient information.

Performs other related duties as necessary and required.

Bachelor's Degree, Master's preferred

Comprehensive knowledge of Government and Third-Party Payors

5 years Revenue Cycle Supervisory experience

Certified Professional Coder (CPC) or any other Professional Billing Certifications, preferred 

EPIC PB Revenue Cycle, ERM and Reporting

Strong Excel skills

Microsoft Business

Excellent written and oral communication skills

Exceptional attention to detail and accuracy