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The Revenue Cycle Manager supervises staff and manages the overall functions of the Mary Washington Healthcare Physicians' professional fee revenue cycle to ensure the accuracy and timeliness of registration, charge capture, charge entry, claims submission, follow-up and account adjudication. The Manager oversees all business-related functions of the patient visit from point of entry to accurate adjudication of the patient's account to include registration, billing and collections, patient insurance, data processing, integrity of patient accounts and accounts receivable management.
Essential Functions & Responsibilities:
Develops work standards, monitors the quality and quantity of processed work, and ensures that policies are communicated and administered consistently. Works closely with practice managers, office managers and site personnel to monitor ongoing compliance to policies and procedures relating to the revenue cycle.
Plans and directs pre-verification of patient insurance, registration, billing and collections, and data processing to ensure accurate patient billing and account collection.
Assists the leadership in establishing annual goals for revenue cycle performance consistent with national benchmarks. Implements specific performance measurement criteria and distributes a "dashboard of key indicators" to the organization's management team.
Identifies and implements methods to automate and streamline revenue cycle processes through use of EPIC operations and reporting.
Manages the evaluation of physician practice patient accounts to identify and resolve billing and processing problems.
Oversees the evaluation of Mary Washington Healthcare Physicians' fee schedule. Oversees credit and collection policies administered by practice staff and co-source vendor personnel. Implements and maintains a system for the collection of delinquent accounts ensuring third-party payers are contacted.
Acts as liaison with outsourced billing vendor and the MWHC Single Billing Office to ensure optimal management of patients' accounts.
Coordinates the exchange of information between the co-source vendor, medical practices, Health Information Management department and other departments to obtain and analyze additional patient information to document and process billing, respond to insurance inquiries and manage liability accounts.
Promotes effective communication between Information Services, co-source billing vendor and front-end staff to ensure ongoing education, training and timely problem resolution. Works with information technology personnel on work processes within the system, submission of electronic claims, claims logistics, development and other functions.
Manages, coordinates, and supervises business operations and staff; responsible for hiring, developing, coaching, mentoring, discipline, and performance evaluations for direct reports. Ensures performance planning, coaching, and evaluation occurs and develops Associates using performance management.
Provides daily supervision of clerical workflow and processes; including physician orders, patient and Associate files, and payroll.
Participates in appropriate meetings as needed.
Performs other duties as assigned.
Bachelor's Degree required.
Minimum of 5 years' experience in revenue cycle operations or physician practice management; 3 years managing patient registration, time of service collections, and charge entry functions in a multi-specialty setting required.
Experience with third-party and insurance company operating procedures, regulations, coding and billing requirements, and government reimbursement programs preferred.
As an EOE/AA employer, the organization will not discriminate in its employment practices due to an applicant's race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status.
A Not-for-Profit Regional Healthcare System Dedicated to Excellence. From our humble beginnings in Fredericksburg, Virginia as an eight-room hospital to our modern not-for-profit regional system, Mary Washington Healthcare has seen enormous growth and development in the past 100 years. Today, we are made up of two hospitals and 28 healthcare facilities and wellness services. Community leaders volunteer on our Board of Trustees in order to guide the continued growth and direction of our health care system.