Revenue Cycle Manager (Finance)
Hospital
Do you enjoy making a difference in a patient's life? Do you want to make a difference in your community? Come work at Parkside! Where healing happens. Every day.
Parkside is a 120 bed, private, non-profit psychiatric hospital, and provides outpatient services as well. Each department works together day in and day out to provide outstanding patient care. Join a team where everyone knows each other and works together towards our mission to provide outstanding mental health and support services. We have a new, innovative CEO that is striving to improve everything from our reach into the community to our company culture. Come be a part of the excitement!
We are seeking a Revenue Cycle Manager! The Revenue Cycle Manager oversees all aspects of the revenue cycle ensuring accurate billing, coding, claims processing, and reimbursement. This role is responsible for optimizing financial performance, maintaining compliance with regulations, and improving operational efficiencies specific to mental health and substance use disorder services. The Revenue Cycle Manager collaborates with clinicians, administrative staff, and insurance providers to enhance revenue flow and reduce denials.
Key Responsibilities:
1. Revenue Cycle Oversight
• Manage the end-to-end revenue cycle for behavioral health services, including intake, pre-authorization, charge capture, claims submission, payment posting, and collections.
• Develop and implement policies tailored to behavioral health billing to optimize reimbursement and reduce revenue loss.
2. Billing & Coding Compliance
• Ensure compliance with behavioral health billing regulations, including Medicaid, Medicare, and private insurance requirements.
• Oversee the accurate use of CPT, HCPCS, and ICD-10 codes specific to mental health and substance use disorder treatment.
• Stay up to date with changes in reimbursement policies, including parity laws affecting behavioral health services.
3. Claims Management & Denial Prevention
• Monitor and analyze claim submissions to identify common denial trends related to behavioral health services.
• Work with clinical and administrative staff to improve documentation and authorization processes to prevent claim rejections.
• Develop corrective action plans to enhance revenue cycle efficiency and minimize lost revenue.
4. Financial Reporting & Analysis
• Generate and analyze reports on revenue cycle performance, identifying trends and opportunities for improvement.
• Provide financial forecasting and key performance indicators (KPIs) to leadership for strategic decision-making.
5. Technology & Process Optimization
• Ensure the effective use of Electronic Health Records (EHR) and billing software for behavioral health services.
• Identify opportunities to automate processes, such as eligibility verification, pre-authorization tracking, and claims follow-up.
6. Patient Financial Services & Insurance Coordination
• Oversee patient billing, financial assistance programs, and payment plan options to improve patient financial experience.
• Work with insurance providers to resolve billing discrepancies and negotiate better reimbursement rates for behavioral health services.
• Educate patients and families on insurance coverage, co-pays, and out-of-pocket costs for mental health treatment.
7. Team Leadership & Training
• Lead, train, and mentor revenue cycle staff, including billing specialists, coders, and financial counselors.
• Conduct regular training sessions on behavioral health billing changes, compliance updates, and best practices.
8. Other duties as assigned.
• Education: Bachelor's degree in healthcare administration, business, finance, or a related field.
• Experience: 5+ years of experience in healthcare revenue cycle management, with at least 2 years in behavioral health billing preferred.
• Technical Skills:
• Strong knowledge of behavioral health billing, including Medicaid, Medicare, and commercial insurance requirements.
• Experience with CPT, HCPCS, and ICD-10 coding for mental health and substance use disorder services.
• Proficiency in EHR and revenue cycle management software.
• Certifications: Certified Revenue Cycle Representative (CRCR), Certified Healthcare Access Manager (CHAM), or Certified Professional Coder (CPC) preferred.
• Excellent problem-solving, communication, and leadership skills. Strong ability to work with clinicians, patients, and insurance providers to improve revenue processes.
Benefits include:
- Medical, Dental, and Vision
- Generous Paid Time Off and Holidays
- 401K and match start immediately, and includes a generous match
- Company Paid Life Insurance and Disability and more!
We are an Equal Opportunity Employer!
