Director, Revenue Cycle Management
Company: CNY Family Care LLP
Location: East Syracuse
Posted on: September 25, 2022
Management position responsible for directing and coordinating
the overall functions of Practices Revenue Cycle. Responsible for
maximizing collections and reimbursement in a cost-effective manner
in compliance with federal, state and payer specific billing
requirements. Ability to build strong patient, physician, and staff
relationships important. Requires strong managerial, leadership,
and business office skills, including critical thinking and the
ability to produce and present detailed billing activity
Duties and Responsibilities include the following. Other duties may
- Oversees the operations of the billing department, encompassing
medical coding, charge/data entry, financial counseling, claims
submissions, payment posting, accounts receivable follow-up,
collection of patient balances and reimbursement management.
- Responsible for producing monthly Revenue Cycle dashboard for
the partner physicians, including but not limited to gross charges;
A/R Days, Copay Collection Rate, Weekly Charges Entered, Weekly
Payments, Total Pre A/R, Denials, Total outstanding A/R; Average
charge per visit, and number of claims submitted. Updates Excel
worksheet with month end numbers by provider. *
- Serves as the practice expert and go to person for all coding
and billing processes. *
- Plans and directs patient insurance documentation, workload
coding, billing and collections, and data processing to ensure
accurate billing and efficient account collection. *
- Maintains contacts with other departments to obtain and analyze
additional patient information to document and process billings.
- Reports at least monthly to executive management and partner
- Prepares and analyzes accounts receivable reports, weekly and
monthly financial reports, and insurance contracts in concert with
the COO/CFO. Collaborates with CFO to contribute to cash
reconciliation activities and to assist in the assessment of
accounts receivable collectability and validation including writing
off bad debts. *
- Responsible for the charge master and for maintaining fee
- Audits current procedures to monitor and improve efficiency of
billing and collections operations. *
- Ensures that the activities of the billing operations are
conducted in a manner that is consistent with overall department
protocol, and are following all practice policies, Federal, State,
and payer regulations, guidelines, and requirements including but
not limited to HIPAA, 42CFR and CMS. *
- Participates in the development and implementation of operating
policies and procedures. *
- Reviews and interprets operational data to assess need for
procedural revisions and enhancements; participates in the design
and implementation of specific systems to enhance revenue and
operating efficiency. *
- Analyzes trends impacting charges, coding, collection, and
accounts receivable and take appropriate action to realign staff
and revise policies and procedures. *
- Performs proactive audits on all recommended A/R write offs and
presents audit results to Executive Management. *
- Identifies and troubleshoots Electronic Interchange (EDI)
issues and works with EHR vendor to correct and implement system
upgrades to maximize practice management system utilization.
- Keep up to date with carrier rule changes, and fee schedules
for all payers and distribute the information within the practice.
- Assist CEO with negotiations and maintenance of payer contracts
with all carriers and payer sources for the practice. Assist with
review of contracted rates versus reimbursements. *
- Understands and remains updated with current coding and billing
regulations and compliance requirements.*
- Maintains a working knowledge of all health information
management issues such as HIPAA and all health
- Maintains library of information/tools related to documentation
guidelines and coding.
- Provides, oversees, and/or coordinates the provision of
training for new and existing billing/front end staff on applicable
operating policies, protocols, systems and procedures, standards,
and techniques. Keeps all practice staff informed of carrier rule
changes and provides training and support to other departments as
- Coordinates team member weekly schedule and time off in a
manner that does not negatively impact necessary daily functions.
Reviews and approves department time in payroll system. *
- Performs other miscellaneous job-related duties as
Manages non-supervisory employees in the Billing Department. Is
responsible for the overall direction, coordination, and evaluation
of these units. Carries out supervisory responsibilities in
accordance with the organization's policies and applicable laws.
Responsibilities include interviewing, hiring, and training
employees; planning, assigning, and directing work; appraising
performance; rewarding and disciplining employees; addressing
complaints and resolving problems. Monitors staff productivity and
implements new quality improvement processes. Compares productivity
and efficiency to national benchmarks. Establishes Key Performance
Indicators, monitors, and reports to executive management.
Motivates employees to achieve peak productivity and
Associates degree, preferably in business administration or related
field. Bachelor's Degree preferred or equivalent combination of
education and experience. Minimum of ten (10) years Medical
Insurance/Healthcare Billing and Collections experience in a
medical practice or health system, with a deep understanding of
medical billing rules and regulations. Five (5) years supervisory
or management experience. A combination of education and experience
will be considered. Certified Professional Coder (CPC) is
Knowledge, Skills and Other Abilities:
- Thorough understanding of medical billing, collections and
payment posting, revenue cycle, third party payers, Medicare;
strong knowledge of NYS and Federal payer regulations.
- In depth knowledge of CMS regulations, processes and carrier's
- Working knowledge of CPT and ICD9/10 codes, HCFA 1500, claim
forms, HIPAA, billing and insurance regulations, medical
terminology, insurance benefits and appeal processes.
- Knowledge of business management and basic accounting
principles to direct the billing and coding office.
- Sufficient knowledge of policies and procedures to accurately
answer questions from internal and external customers.
- Possess excellent negotiation skills, including the tact
required for securing payment or discussing patient's finances, and
enjoy working in a health care setting.
- Up to date with health information technologies and
- Knowledge of clinic's strategic business objectives and
employee performance objectives.
- Knowledge of governmental and health care fiscal regulations
and reporting requirements.
- Experience with physician credentialing process.
- Skill in exercising a high degree of initiative, judgment,
discretion, and decision-making to achieve objectives.
- Skill in evaluating operations as they relate to policies,
goals and objectives, costs, and rate levels.
- Skill in establishing and maintain effective working
relationships with patients, medical staff, and the
- Detail oriented and tolerant of frequent interruptions and
distractions from patients and staff.
- Skill in identifying and resolving accounting and financial
- Ability to create an atmosphere that encourages motivation,
innovation, and high performance.
- Ability to delegate responsibility and authority to
- Ability to work under minimum supervision and demonstrate
- Ability to supervise and train employees, to include
organizing, prioritizing and scheduling work assignments to meet
- Ability to deal in an organized manner with problems involving
multiple variables within the scope of the position.
- Ability to communicate effectively with physicians, patients,
insurers, colleagues and staff.
- Ability to make independent decisions when circumstances
warrant; make prompt and accurate judgments regarding AR, billing
and other office duties.
- Ability to recognize, evaluate, solve problems, and correct
errors, and to develop processes that eliminate
- Ability to conceptualize workflow, develop plans, and implement
- Ability to communicate effectively in writing, over the
telephone, and in person.
Keywords: CNY Family Care LLP, Syracuse , Director, Revenue Cycle Management, Executive , East Syracuse, New York
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