RCM Supervisor

Job DetailsJob Location:

Congress Billing LLC - Delray Beach, FL 33445

Position Type:

Full TimeSalary Range:

$60,000.00 - $75,000.00

Salary/yearTravel Percentage:

NegligibleJob Shift:

Day (First Shift)

POSITION PURPOSE

The purpose of the RCM (Revenue Cycle Management) Supervisor position is to oversee and manage the revenue cycle functions within a healthcare organization. The RCM Supervisor is responsible for ensuring the proper identification, collection, and management of revenues from patient services. They play a crucial role in unifying the business and clinical aspects of healthcare by coupling administrative data with the treatment a patient receivesQualifications

EDUCATION

Minimum of High School Diploma or Equivalent required. Minimum of three years progressive related experience; or equivalent combination of education and experience. Bachelor's degree in business or related field a plus.

EXPERIENCE

Minimum 3 years of management experience within a hospital or medical billing company setting. Proven knowledge of Rev, CPT and

ICD-10 CM

coding (medical, mental health and substance abuse preferred). Integral knowledge of the A/R process. Proven managerial success in analyzing A/R reports. Proven successful management skills.

LICENSURE/CERTIFICATION

Current

CPR AGE SPECIFIC INDIVIDUALS SERVED/ RESPONSIBILITY

Adult

KNOWLEDGE AND TRAINING REQUIRED AT TIME OF HIRE

Knowledge of the Principles and Practices of the discipline. Knowledge of Joint Commission Standards. Demonstrates Proficiency in Communication & Written skills. Knowledge of State & Federal Statutes Regarding Client Confidentiality laws. Knowledge of Drug-Free Workplace Policies. Knowledge of Workplace Violence Strong computer skills with knowledge of various EHR systems Comprehensive knowledge of revenue cycle business office practices Proficiency in Revenue Cycle Management Systems, Learning Management Systems, Microsoft Office, database and spreadsheet analysis, and presentation programs Understanding of federal, state, and private payer regulations as well as applicable organizational policies and procedures

SPECIFIC AREAS OF RESPONSIBILITY TO POSITION

Maintain knowledge of the operational details of all positions in the Revenue Cycle Management process, which includes but is not limited to insurance claim submission, clearinghouse and payor claim rejections, payment posting, insurance claim denial management, Verification of Benefits, OON payer, underpayment repricing. Initiate modifications of all procedural paperwork related to accounts receivable-encounter forms, billing, verifications, etc. Meet with Billing and Collections staff monthly to analyze A/R reports, days in receivable, and collection statistics. Perform weekly billing audits to ensure timely and accurate processing of charge and payment posting. Conduct detailed audit of Explanation of Benefits forms from commercial and managed care payors at least biweekly; prepares or presents results to Executive Management. Meet with Collections staff to discuss difficult claims and provide solutions. Meet with Billing and Collections staff monthly to discuss key issues, overall accounts receivable performance, and opportunities for improvement. Train and oversee performance of Billing, Collections and Verification staff; assist with recruitment, discipline, and termination. Monitor overall workload in the department and distribute work, accordingly, ensure all posts are filled in case of vacation and sick days. Maintain fee schedule as well as

CPT, ICD-10

CM, adjustment, payment, and payor files in the computer system. Maintain and distribute payment contracted schedules as received from contracted carriers, input/update schedule into computer system. Request payment schedules from contract carriers as needed. Prepare fee/payment comparative report quarterly. Maintain carrier contract files and the Compliance Binder. Complete all credential applications and reapplications as requested. Seek and recommend ways to use technology to improve operational efficiency. Maintain patient confidentiality by following the HIPAA Compliance Plan established by the practice. Attend all meetings as requested and perform any additional duties as requested by Executive Management Protect the privacy of all patient information in accordance with the company's privacy policies, procedures and practices, as required by federal and state law, and in accordance with general principle of professionalism as a healthcare provider. Failure to comply with the company's policies and procedures on patient privacy may result in disciplinary action. Potential access to protected health information (PHI) and other patent information only to the extent that is necessary to complete your job duties. The incumbent may only share such information with those who have a need-to-know specific patient information you have in your possession to complete their job responsibilities related to treatment, payment or other operations. Report, without the threat of retaliation, any concerns regarding the company's policies and procedures on patient privacy and any observed practices in violation of the policy to their supervisor. Perform other duties assigned.

Qualifications:

EDUCATION

Minimum of High School Diploma or Equivalent required. Minimum of three years progressive related experience; or equivalent combination of education and experience. Bachelor's degree in business or related field a plus.

EXPERIENCE

Minimum 3 years of management experience within a hospital or medical billing company setting. Proven knowledge of Rev, CPT and

ICD-10 CM

coding (medical, mental health and substance abuse preferred). Integral knowledge of the A/R process. Proven managerial success in analyzing A/R reports. Proven successful management skills.

LICENSURE/CERTIFICATION

Current

CPR AGE SPECIFIC INDIVIDUALS SERVED/ RESPONSIBILITY

Adult

KNOWLEDGE AND TRAINING REQUIRED AT TIME OF HIRE

Knowledge of the Principles and Practices of the discipline. Knowledge of Joint Commission Standards. Demonstrates Proficiency in Communication & Written skills. Knowledge of State & Federal Statutes Regarding Client Confidentiality laws. Knowledge of Drug-Free Workplace Policies. Knowledge of Workplace Violence Strong computer skills with knowledge of various EHR systems Comprehensive knowledge of revenue cycle business office practices Proficiency in Revenue Cycle Management Systems, Learning Management Systems, Microsoft Office, database and spreadsheet analysis, and presentation programs Understanding of federal, state, and private payer regulations as well as applicable organizational policies and procedures

SPECIFIC AREAS OF RESPONSIBILITY TO POSITION

Maintain knowledge of the operational details of all positions in the Revenue Cycle Management process, which includes but is not limited to insurance claim submission, clearinghouse and payor claim rejections, payment posting, insurance claim denial management, Verification of Benefits, OON payer, underpayment repricing. Initiate modifications of all procedural paperwork related to accounts receivable-encounter forms, billing, verifications, etc. Meet with Billing and Collections staff monthly to analyze A/R reports, days in receivable, and collection statistics. Perform weekly billing audits to ensure timely and accurate processing of charge and payment posting. Conduct detailed audit of Explanation of Benefits forms from commercial and managed care payors at least biweekly; prepares or presents results to Executive Management. Meet with Collections staff to discuss difficult claims and provide solutions. Meet with Billing and Collections staff monthly to discuss key issues, overall accounts receivable performance, and opportunities for improvement. Train and oversee performance of Billing, Collections and Verification staff; assist with recruitment, discipline, and termination. Monitor overall workload in the department and distribute work, accordingly, ensure all posts are filled in case of vacation and sick days. Maintain fee schedule as well as

CPT, ICD-10

CM, adjustment, payment, and payor files in the computer system. Maintain and distribute payment contracted schedules as received from contracted carriers, input/update schedule into computer system. Request payment schedules from contract carriers as needed. Prepare fee/payment comparative report quarterly. Maintain carrier contract files and the Compliance Binder. Complete all credential applications and reapplications as requested. Seek and recommend ways to use technology to improve operational efficiency. Maintain patient confidentiality by following the HIPAA Compliance Plan established by the practice. Attend all meetings as requested and perform any additional duties as requested by Executive Management Protect the privacy of all patient information in accordance with the company's privacy policies, procedures and practices, as required by federal and state law, and in accordance with general principle of professionalism as a healthcare provider. Failure to comply with the company's policies and procedures on patient privacy may result in disciplinary action. Potential access to protected health information (PHI) and other patent information only to the extent that is necessary to complete your job duties. The incumbent may only share such information with those who have a need-to-know specific patient information you have in your possession to complete their job responsibilities related to treatment, payment or other operations. Report, without the threat of retaliation, any concerns regarding the company's policies and procedures on patient privacy and any observed practices in violation of the policy to their supervisor. Perform other duties assigned.