ESSENTIAL FUNCTIONS:

1. Plan, direct, coordinate, and supervise: credentialing, billing, insurance verification, payment posting and collections activities.
2. Engage across multiple functions within Cenikor, to ensure processes, tools, and controls are operating optimally relative to timely claims submission, collections, cash flow, accounts receivable, bad debt, regulatory requirements, and revenue cycle resource efficiency.
3. Investigate trends in reimbursement from third party payers and instances of low reimbursement establishing proactive planning with billing and collections team to resolve variances.
4. The RC Manager will be responsible for payer escalation to provider relations, identifying payment trends, interpreting denial trends to maximize collection rates.
5. The position supports the company's objective of efficiently and effectively providing management, oversight and assurance that clients' cash collections, adjustments and accounts receivable balances are accurate and meet client benchmarks and expectations.
6. Management responsibility for Cenikor's Claims/Collections/Cash Posting function, including support staff and establishment of goals and objectives.
7. Leads activities associated with identifying Revenue Cycle opportunities and exposures, assessing alternatives, delivering recommendations to management, supporting implementation to chosen alternatives, and optimizing outcomes in association with overall business objectives.
8. Develops, maintains, monitors and implements actions in association with revenue cycle specific business Performance Metrics and People Performance Metrics.
9. Interacts weekly and collaboratively with payer trending, changes and/or alterations to work instructions, reviews productivity outputs, cash trends and viable opportunities to increase cash.
10. Drive the Coaching Process to effectively relay performance metrics to staff, and facilitate RCA and Action Planning to resolve and/or mitigate performance issues
11. Revenue Cycle responsibilities spanning all existing businesses and supports definition and implementation of Revenue Cycle requirements in association with future businesses
12. Manages the successful capture of charges and payment posting to ensure the timely completion of month end close activities.
13. Ensures Revenue Cycle goals are always aligned with overall Business Goals and Objectives of Cenikor
14. Perform additional duties as assigned and consistent with the exempt functions as defined in this job description.

QUALIFICATIONS FOR THE POSITION:

Skills, Knowledge and Abilities:

Proven quantitative, analytic and data driven decision making skills to effectively evaluate challenges and opportunities that facilitate appropriate and timely decisions.

• Strong project management skills
• Knowledgeable in billing and coding rules and guidelines
• Advanced proficiency in Microsoft office with specific focus on Microsoft Excel.
• Demonstrate excellent verbal/written communication skills, excellent organization and leadership skills.
• This role requires an in-depth understanding of the healthcare revenue cycle stream between payers and a provider. This will include all aspects of the revenue cycle including eligibility, benefit plan design / setup, billing, claim adjudication, and reconciliation.
• Ability to consistently uphold the Core Principles of Cenikor's Culture:
  • o Demonstrate mission of service to our clients
• o Positive, respectful communication with both staff and clients
• o Demonstrate self-motivation and perseverance to achieve goals
• o Role model appropriate, professional behaviors including appropriate client boundaries
• o Work effectively as part of a team, helping to set up others for success

Education:

• Bachelors in Business or Healthcare Administration

Experience:

• 5 years of hospital or physician revenue cycle required
• 3 years of management required

Certification Required:

• Medical billing and coding certification preferred.

Physical Requirements:

• Sitting in normal position for extended periods of time.
• Reaching by extending hand(s) or arm(s) in any direction.
• Finger dexterity required to manipulate objects with fingers rather than with whole

hand(s) or arm(s), for example, using a keyboard.

• Communication skills using the spoken word.
• Ability to see within normal parameters.
• Ability to hear within normal range.
• Ability to move about.