Job Details

Revenue Cycle Manager

As the Revenue Cycle Manager for HOPE Clinic, you focus on partnering with our patients to clearly understand their institutional goals, challenges, organizational structure, and key business drivers. The role of the Revenue Cycle Manager oversees the Billing and Insurance Verification team's daily activities and follows up with teams to drive the overall performance and daily management of multiple assigned providers' schedules. The Revenue Cycle Manager serves as a liaison between the Billing and Insurance Verification team and other HOPE Clinic departments and the patients.

Major duties and responsibilities include managing overall medical billing operations, overseeing aggressive follow-ups with accounts receivables, tracking fee schedules and insurance denials, identifying and implementing strategies to improve internal and patient billing processes, incorporating and executing quality assurance processes, reviewing and analyzing patient accounts, collaborating with other team members to improve the overall positive work environment, providing high-level customer service to both practices and patients, collaborating with the front desk, call center, and other departments as needed to resolve any billing/payor issues, researching, compiling the necessary documentation, and completing the appeal process for denied claims, preparing, reviewing, and transmitting claims using billing software, following up on unpaid claims within the standard billing cycle timeframe, collaborating with the billing team when necessary to make coding changes to submit corrected claims or appeals, staying current with payer trends, analyzing root causes of denials, identifying areas of concern regarding the various areas of the revenue cycle, sharing trending and feedback to reduce denials to the CFO and/or Credentialing Coordinator, hospital billing, applying insurance and patient payments to the Practice Management system, utilizing ERAs and manual application, reconciling payments applied to the system to cash received, answering patient's estimate of benefits or statements, telephone inquiries verifying insurance and benefits within the practice management system, attending on-site/off-site community engagement activities, clinic events, and/or training as needed, and performing other duties as assigned to support HOPE Clinic's Mission, Vision, and Values.

Qualification requirements include 5-7 years of experience with revenue cycles, medical billing, collections, and payment posting, understanding regulatory and compliance requirements associated with submitting claims to payers, experience with Electronic Medical Records (EMR), strong communication and interpersonal skills, expertise with medical and billing terminology, excellent organization and time management skills, and proficiency in computers, particularly Word and Excel.

Education and/or experience include a Bachelor's degree from a four-year college or university (desired), or 5-7 years related experience and/or training; or equivalent combination of education and experience, 1-2 years of supervisory experience, knowledge of medical billing, front-office, physician practice management, and healthcare business processes, strong understanding of medical billing/coding, with an understanding of various insurance carriers, including Medicare, private HMOs, and PPOs, and previous FQHC (Federally Qualified Health Center) RCM experience.

Other skills and abilities include bilingual (Vietnamese, Chinese, Arabic, and/or Spanish with English) is preferred, above average skills in language ability as well as public speaking and writing, and must have good transportation and a valid Texas Driver's license.