Vista Community Clinic
Revenue Cycle Manager
Vista Community Clinic is a private, non-profit, multi-specialty outpatient clinic providing care in a comprehensive, high quality setting. Located in San Diego, Orange and Riverside counties, we work to advance community health and hope by providing access to premier health services. We are looking for dedicated, motivated, enthusiastic team players who want to make a difference in the community. Our competitive compensation and benefits program includes health, dental, vision, company-paid life, flexible spending accounts and a 403(B) plan, for eligible employees. VCC is an equal opportunity employer.
Under general supervision of the Director of Revenue Cycle, the Revenue Cycle Manager manages the functions of the organizations pre-billing, coding, and other revenue cycle activities in order to maximize efficiencies and revenue opportunities while maintaining and improving internal and external customer relations, including serving as VCCs primary revenue cycle-related point of contact for all contracted health plans. In conjunction with billing staff, this position will contribute to the day-to-day operations on all issues related to the revenue cycle function, provide analysis, create written processes, and train others in implementing a cross functional revenue cycle team
- Maximize revenue and ensure compliance with contract changes/updates, additions, termination of payers, coding issues, and/or reimbursement issues.
- Ensure timely receipt and submission on all pre-billing and coding functions
- Monitor and report on coding and/or reimbursement trends and issues that have an impact on the financial result, site needs, and internal workflow.
- Develop, implement and monitor of Billing Department policies and procedures
- Maintain a leadership role and direct involvement with VCCs Managed Care Plan organizations and contracted Commercial payers, keeping updated on any and all contract changes, billing requirements, updates, issues, etc., and helping to ensure that VCC meets all Plan requirements.
- Oversee billing-related clinician training process
Provide functional direction to assigned staff.
Recommend or make decision to hire, transfer, and suspend layoff, recall, promote, discharge, assign, reward or discipline.
Assess training needs and promote developmental activities.
Conduct department meetings to promote communication, assess and resolve needs and foster teamwork
- Bachelors degree or equivalent combination of education and experience
- Minimum three years successful billing supervisory experience
- Minimum five 5 years billing and collection experience in a health care facility
- Demonstrated record of continuing education/training and professional development.
- Strong team player and leadership skills.
- Ability to perform critical work under deadlines.
- Excellent working knowledge of patient financial service operations with focus on public insurance, and managed care
- Broad knowledge of the healthcare industry, including insurance, managed care, and integrated delivery systems
- Working knowledge of financial statements and the impact of the revenue cycle on them, aging reports, bad-debt analysis, and calculation of bad-debt allowance
- Working knowledge of patient registration, billing, A/R, cash-management requirements, managed care contractual terms and requirements, health insurance practices and industry regulatory requirements
- Ability to recognize and analyze the impact of regulatory changes on the financial performance of professional revenue and to establish and utilize performance measures throughout the revenue cycle process
- Experience/familiarity with computers, Microsoft Office products (Word/Excel), business e-mail communication systems and internet search capabilities