Revenue Cycle Manager

Revenue Cycle Manager

Founded in 2001, Pasadena Villa has treated mental health conditions for all genders ages 18 and older, along with specialty residential programs for autistic clients. Our customized and compassionate care is provided in a therapeutic environment that promotes well-being, recovery, and personal motivation. There are multiple levels of care available at each of our Pasadena Villa locations, each providing the highest levels of care and support and the closest amount of supervision needed.

The Revenue Cycle Manager reports directly to the Director of Financial Operations and is responsible for oversight of patient accounting functions for both Insurance and Privately funded clients. The Revenue Cycle Manager helps improve cash flow and participates in managing the overall health of the company's receivables.

Initiates and maintains frequent and close working relationships with staff and peers throughout the organization. Maintains working relationships with community partners, health insurance companies, prospective and current clients as well as company vendors.

Manages the business office team. Prepares/oversees daily Census functions. Lead month end process for assigned facilities. Excellent customer service with the ability to communicate to both insurance companies as well as families in the efforts of collecting outstanding balances. Understands all aspects of revenue cycle management to answer team questions. Monitors UR/Billing census daily to ensure completeness and accuracy. Manages manual billing activities for assigned facilities, including identifying and taking corrective action where needed to improve processes. Ensure accurate charge entry and billing including coverage for those on PTO. Ensure accurate, timely and complete account follow-up including coverage for those on PTO. Confirm accounts are worked to completion including all payments and adjustments are entered correctly. Monitors business office staff productivity. Monitors timely entry and application of all payment received. Utilizes system reports to reconcile payments posted in management systems. Document all activity taken on an account in the patient account notes. Effectively identifies trends that inhibit timely payment. Confirms claims are worked within the established productivity standards, for timely follow-up maintaining and updating all patient accounts to reflect current information. Reviews accounts for accuracy including account balance, payer plan and financial class, level of care, denials, and insurance requests. Review credit reports and process applicable refunds to patient or insurance carrier. Understand and interpret insurance Explanation of Benefits, knowing when and how to ensure that payment has been received. Respond in a professional and timely manner to all billing-related inquiries from patients, guarantors, staff, and payers. Understands authorizations and limits to coverage such as the number of authorizations/units. Documents, analyzes, and trends billing and collection activities and communicates to supervisor as appropriate. Coordinates with the facility and medical records for resolution of disputed / denied claims. Provides ongoing feedback and coaching to the team. Trains team on updated processes/new processes. Leads training for new revenue cycle staff. Provide support on special or large analysis projects. Responsible for coordinating all new revenue cycle/business office staff onboarding and training.

Qualifications

Education and Experience

• 3- years' experience supervising teams
• 3-5 years' experience with insurance billing and collections.
• 3-5 years' experience acting as a liaison between insurance companies and family members/guarantors.
• Prior experience in Mental Health, Substance Abuse Disorder Treatment, or behavioral healthcare field preferred

Renaissance Health Care Group, LLC d/b/a Pasadena Villa provides equal employment opportunities without regard to race, color, creed, ancestry, national origin, ethnicity, sex, gender, sexual orientation, marital status, religion, age, disability, gender identity, genetic information, service in the military, or any other characteristic protected under applicable federal, state, or local law. Equal employment opportunity applies to all terms and conditions of employment. Renaissance Health Care Group, LLC d/b/a Pasadena Villa reserves the rights to modify, interpret, or apply this job description in any way the organization desires. This job description in no way implies that these are the only duties, including essential duties, to be performed by the employee occupying this position. Reasonable accommodations may be made to reasonably accommodate qualified individuals with disabilities. This job description is not an employment contract, implied or otherwise. The employment relationship remains "At-Will."