Revenue Cycle Manager

Since 1996, Surgical Information Systems (“SIS”) has been dedicated to providing surgical care providers with the solutions and services they need to deliver improved operational, financial, and clinical outcomes. Focused exclusively on perioperative IT, SIS serves over 2900 facilities across the United States and Canada.

 

The SIS product suite is built specifically for the perioperative environment and includes hospital and ASC-focused solutions covering perioperative Electronic Medical Records (EMRs), Anesthesia Information Management Systems (AIMS), ASC business management, and business intelligence and analytics solutions.  SIS’ AmkaiCharts™ solution, is the No. 1 ranked outpatient EMR[1].  Services, including revenue cycle management and ASC advisory services, complement SIS’ software solutions.

 

For more information, visit SISFirst.com.

 

SIS, the SIS logo, and Surgical Information Systems are trademarks of Surgical Information Systems, LLC. AmkaiSolutions, AmkaiCharts, AmkaiOffice, and AmkaiAnalytics are trademarks of Amkai LLC. AdvantX, Vision, and SurgiSource are trademarks of Source Medical. Other company and product names may be trademarks of their respective owner.

 

[1] Black Book Research Rankings – April, 2017 http://www.blackbookmarketresearch.com/ambulatory-alternate-site-ehr/  and “Top Ambulatory Electronic Health Records Vendors Comparative Performance Result Set of Top EHR Vendors,” May 2016.

THIS IS A REMOTE POSITION

The Revenue Cycle Manager (RCM) will lead a revenue cycle team/region offering direct supervision to assigned managers with proactive communication towards decision and actions that will assure success. The RCM will accomplish clearly defined results for clients in a multi-client medical billing service. As a leader of other direct contributors, this manager’s role will be to develop and implement consistent strategies focused on driving best-in-class service, quality results, responsiveness and direction to assigned clients. To meet objectives, the RCM will partner closely with other RCMs, the Sr. Managers, their assigned clients, and others as necessary to determine and support the staffing, tools, coaching and training needs of the region.

ESSENTIAL DUTIES/ RESPONSIBILITIES:

• Drives commitment to accomplishing consistent, quality daily results – the hours are routine business hours. Examples:
• Drives results by focusing on high productivity and quality work. On a weekly basis, or as necessary, the RCM coaches team members to develop a work plan focusing on time management, organization, and metrics.
• Dependent upon the specific part of revenue cycle that you oversee your role will encompass the following responsibilities: 

Posting:

• Review client cash summary
• Review posting folder in SharePoint
• Review account for application of payments
• Weekly review of ERA/EFT/ACH enrollments
• Weekly full-scale reconciliation of cash summaries
• Review payments and adjustment transactions to ensure proper JC is used
• Resolve Waystar balances and reporting on out of balance amount
• Manage month end duties included confirmation of all refunds posted and total dollars of all posted refunds, total collections recovery for the month, confirm all payment posting batch closed, confirm total recoupments, confirm all month end reports are run.

Billing:

• Review billing for clients by reviewing and resolving billing queries, confirming the billing team resolved the answers to previous days’ queries, QA for problematic/high priority cases for charges entered, Client hard post transactions, submission of posted charges via Waystar, paper/Waystar, paper/non Waystar, and Fax
• Manage Waystar rejections and fix COB errors
• Ensure billing rules are kept current and followed
• Reconcile unbilled cases against PAS on a minimum of a weekly basis
• Complete end of month duties
• Review the unbilled report by sharing the client unbilled report weekly and review the unbilled report daily for discrepancies or issues
• Responsible for the forward to billing queue weekly.
• Maintaining regular open communication with coding department

Accounts Receivable:

• • Push Wednesday – Each week (exception End of Month week), the RCM will process a “soft close”.  The actions taken will focus on “if closing was today, the center and RCS would be ready to close”. A report will be shared with the team and clients by noon the next day documenting all billable cases are billed, all RFIs are up-to-date and escalated as appropriate, all cash is posted and trued-up so that should the period need to be closed all would be ready.
  • Credit Balances –The RCM will verify that credit balances are being worked as per policy. In general, payment posting resulting in a new credit balance will be worked and documented within 10 business days and, when necessary a refund request processed within 15 business days.
  • AR Follow-up Metrics –The RCM will validate quantity and quality are being maintained at 90%-94% to meet expectations and 95% or better to exceed.  If not, the RCM will report to the CSM the specifics to each situation and set goals to catch up.
• Consistently measures and evaluates associates based on established goals and objectives for individual positions. On a routine basis, meets with associates to provide direct feedback and guidance one on one at least monthly and more often when necessary.
• Strives to meet established, and updated, key performance indicators (KPIs) and proactively suggests, develops and implements changes necessary to do so.
  • Timely Closing – centers will be closed on or before the 5^th business day to meet expectations and on or before the 3^rd business day to exceed.
  • Days to Bill/Lag Days – goals are client specific and can change from time to time but generally need to be maintained at 5 days or less.
  • AR > 90 Dollars – goals, ie…”the floor”, are client specific and maintaining the AR within percent of the floor either way meets expectations; beating the goal by 2 points or better exceeds expectations.
  • Credit Balances – goals are set per client and are expected to be met. Accurate credit balances, refund requests sent monthly via a list that builds upon itself with accounts only dropping off when refunds are processed, and accounts being noted with all details including the monthly update each time a request is sent meets expectations when audit documents results at 90% to 94% and exceeds when results are 95% or better.
  • Expenses- human resource expenses (ie. FTEs) are managed so that the region operates as efficiently and effectively as possible. 

RCMBrain:

• Resolve Queue daily
• Effectively and actively participates in routine and non-routine meetings, performance improvement planning, project development and plan execution.
• Responds to leader, client and associate’s questions and concerns with data and analytical observations geared towards providing direction.
• Coaches performance to move associates forward towards accomplishing goals, and moves associates out timely when results aren’t forthcoming.
• Works directly with Human Resources to review applications, arrange for interviews and interview applicants to obtain information on work history, training, education, and job skills. Recommends hiring decisions and explains why and why not.
• Orients and trains employees on established policies, procedures, equipment, software, etc. documenting progress and competency.
• Consistently meets budgeted revenue and expense expectations.
• Ensures compliance with applicable employment laws and regulations in all areas including but not limited to Equal Employment Opportunity (EEO) and affirmative action guidelines and laws, such as the Americans with Disabilities Act (ADA).
• Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time

EDUCATION DESIRED:

High school graduate or GED certification, AA degree in Management Preferred

 

SPECIFIC KNOWLEDGE & SKILLS DESIRED:

• 3-5 years of experience in managing
• Experience in Ambulatory Surgery Center, Surgical Hospital or Hospital Billing
• Experience with managing forecasting, scheduling, and load balancing
• Experience with performance management/coaching activities across high-performing teams
• Experience with interviewing candidates and selecting talent according to the needs of the team
• Superior customer service skills and orientation
• Strong critical thinking analytical and problem solving skills
• Effective interpersonal skills (written and oral) and the ability to communicate effectively with a variety of staff levels
• Excellent organizational skills, and ability to manage multiple projects and competing tasks/priorities
• Prior experience in a medical setting or call center environment strongly preferred
  
  

 

SUPERVISORY RESPONSIBILITIES:

Will have a team of direct reports and clients to lead/manage.

 

 

 

BENEFITS:

• Benefit package including Medical, Vision, Dental, Short Term Disability, Long Term Disability, and Life Insurance
• Vacation/Sick time
• 401(k) retirement plan with company match
• Paid Holidays
• SIS Cares Day
• Hybrid or Remote environment depending on the role