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The Manager, Revenue Cycle Management & Patient Access is responsible for leading Revenue Cycle Management activities to include billing, collections, revenue integrity auditing, charge master management, fee schedule management, 855b application, medical claims management (including denials and appeals operations), cash application to include managing receivables and cash collections to an acceptable level from front end Patient Access Team and back-end collections. This position ensures maximum collection efficiency while creating a culture of accountability and service to our patients. This position is responsible for developing and implementing strategies and processes to continuously improve and manage the patient access and revenue cycle in a fast-paced, high-volume, evolving healthcare market. Additionally, this role is responsible for overseeing the overall policies, objectives, and initiatives of revenue cycle activities to optimize patient financial interaction. This role conveys insurance payor challenges, payment errors, denials, etc. to third-party insurance payor contract negotiators.

Duties and Responsibilities, including but not limited to:

• Directs, supervises, and coordinates overall Revenue Cycle Management (RCM) functions and activities in accordance with standards established by institutional, governmental, and other regulatory entities. Serves as a facilitator and intradepartmental team builder, primarily with Patient Access and Reimbursement teams.

• Oversee facility operations of Patient Access functions (e.g. pre-registration, benefit verification, pre-authorization, service pre-payment, etc.) to ensure daily operations are maintained according to standard.

• Runs, reviews, interprets, analyzes, and validates Revenue Cycle reports. Ensures the integrity of data provided to all areas of the revenue cycle and other areas of the organization is necessary for good decision making.

• Responsible for oversight of the daily operations regarding insurance benefits, patient assistance, patient account management, and case management, including but not limited to benefit verification, prior authorization, copay assistance, and communication of patient financial responsibilities.

• Ensures the integrity of data provided to all areas of the revenue cycle and other areas of the organization is necessary for good decision making.

• Leads the development and implementation of revenue cycle strategies, processes, and improvement initiatives to continuously improve the RCM process to maximize the Company’s billings and collections.

• Drives the design, execution, monitoring, and assessment of key RCM performance metrics to refine processes and improve efficiencies and productivity to reduce overall costs.

• Manages vendor relationships and works with our service provider(s) to deliver agreed-upon results, and drive cost, quality, and process improvement by establishing well-defined processes, sharing best practices, and ensuring effective working relationships.

• Ensures compliance in all aspects of RCM activities including coding and billing rules and regulations by payer and state by maintaining knowledge of third-party payor regulations including Medicare, Medicare Advantage, Medicaid, Workers Compensation, and non-governmental payers.

• Ensures processes occur accurately and timely within assigned areas, Patient Access and Billing, holding the team accountable for driving results.

• Maintains knowledge of third-party payor regulations including Medicare, Medicare Advantage, Medicaid, Workers Compensation, and non-governmental payers.

Basic Qualifications:

• Bachelor's degree or equivalent in Healthcare Administration, Health Information Management, or related field or Minimum of 5+ years of experience in healthcare reimbursement (RCM) required.

• 5 years of work experience with Revenue Cycle Management & Patient Access required

• Extensive comprehensive working knowledge & proficiency HCPCS, diagnostic and procedural coding such as ICD-10, CPT and HCPCS required.

• Proficiency in medical billing software and electronic health record (EHR) systems required.

• Strong knowledge of healthcare billing and coding practices, reimbursement methodologies and revenue cycle required.

Certifications (one of the following required):

• Certified Coding Specialist (CCS)

• Certified Professional Coder (CPC)

• Certified Evaluation & Management Coder (CEMC)

• Certified Hematology & Oncology Coder (CHONC)

• Certified Professional Medical Auditor (CPMA)

• Certified Coding Associate (CCA)

• Registered Health Information Technician (RHIT)

• Registered Health Information Administrator (RHIA

Preferred Qualifications:

• Membership or affiliation with American Urology Association, MGMA and/or HFMA is preferred

• Athena experience preferred

Schedule/Compensation Details:

• Employment Status: Full time (1.0 FTE)

• Weekly Scheduled Hours: 40

• Hours of work: 8:00 a.m. to 5:00 p.m.

• Days worked: Monday to Friday

At BAMF Health, our top priority is patient care. To ensure we are able to drive a Bold Advance Medical Future, we offer a well-rounded benefit package to care for our team members and their families. Highlights include:

• Employer paid High Deductible Health Plan with employer HSA contribution

• Flexible Vacation Time

• 401(k) Retirement Plan with generous employer match

• Several benefit options including, but not limited to; dental, vision, disability, life, supplemental coverages, legal and identity protection

• Free Grand Rapids downtown parking

Disclaimer

BAMF Health provides equal opportunities to all employees for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

BAMF Health will reasonably accommodate qualified individuals with a disability so that they can perform the essential functions of a job unless doing so causes a direct threat to these individuals or others in the workplace and the threat cannot be eliminated by reasonable accommodation or if the accommodation creates an undue hardship to BAMF Health.

BAMF Health is an Equal Opportunity Employer and will not accept or tolerate discrimination or harassment against any applicant, employee, intern, or volunteer based upon the following characteristics: race, color, religion, creed, national origin, ancestry, sex, age, qualified mental or physical disability or handicap, sexual orientation, gender identity/expression, transgender status, genetic information, pregnancy or pregnancy-related status, marital status, veteran status, military service, any application for any military service, or any other category or class protected by applicable federal, state, or local laws.