Revenue Cycle Manager

Key Requirements:

• Commitment to advancing race (+) equity in one’s work: interested in expanding knowledge about the role that racial inequity plays in our society
• Awareness of multiple group identities and their dynamics, bringing a high level of self-awareness about personal identity, empathy, and humility to interpersonal interactions
• Demonstrated ability to communicate clearly and directly as well as hear and act on feedback related to identity and equity with the aim to learn
• Strong sense of accountability to equitable practices
• Understanding of the impact of identity dynamics on organizational culture
• Commitment to PPSP’s In This Together service ethos, workplace values, and service standards

ESSENTIAL FUNCTIONS:

• Lead, direct and coordinate daily ERA, EOB, and patient payment posting and billing. Ensure month-end reconciliation processes are completed on time and accurately
• Analyze self-pay balances, trends, and identify training needs. Collaborate with training team to ensure training materials adequately address any identified problems
• Ensure PPSP’s KPIs are satisfied. Monitor and report on progress, challenges, and solutions to internal stakeholders
• Conduct follow-up with team members and provider reps to track action items and affiliate progress
• Implement and manage workflow change
• Ensure month-end activities are completed in a timely manner and that month-end reconciliation is accurately completed
• Coordinate, participate in, and manage communications (calls, updates) as needed with internal and external stakeholders (e.g. affiliate staff, payer groups)
• Run appropriate Epic reporting to track and monitor payer-specific claim adjudication trends
• Provide detailed weekly/monthly/quarterly reporting, as needed, for management review
• Submit daily electronic and paper claim files, and correct all claim and charge review edits, warnings and errors; run statement files; and download ERAs/EOBs as needed
• Maintain relationships with contracted payers, and other contracted entities to ensure maximum reimbursement.
• Audit work of reimbursement specialists and insurance benefit verification specialists; arrange for any needed retraining or provide areas for improvement, as applicable
• Oversee and improve billing and collection strategies and systems
• Perform payment posting functions, participate in billing line call center, and claim follow-up as needed
• Participate in Revenue Cycle team meetings/conference calls, and provide the necessary reporting, feedback, and training required to improve processes
• Complete special projects as needed


• The above duties and responsibilities are not an exhaustive list of required responsibilities, duties, and skills. Other duties may be added, and this job description can be amended at any time. 

KEY REQUIREMENTS:

• Commitment to advancing race (+) equity in one’s work: interested in expanding knowledge about the role that racial inequity plays in our society 
• Awareness of multiple group identities and their dynamics, bringing a high level of self-awareness about personal identity, empathy, and humility to interpersonal interactions 
• Demonstrated ability to communicate clearly and directly as well as hear and act on feedback related to identity and equity with the aim to learn
• Strong sense of accountability to equitable practices 
• Understanding of the impact of identity dynamics on organizational culture 
• Commitment to PPSP’s In This Together service ethos, workplace values, and service standards 

QUALIFICATIONS AND EXPERIENCE:

• Required: 
• Bachelor’s Degree or equivalent experience required.
• At least five years’ experience in medical billing and Accounts Receivable management.
• Experience with patient billing and demonstrable understanding of the nuances of grants or entitlement programs
• Minimum 3 years’ experience using Epic and/or NextGen EPM/EHR software at a high level of competence 
• Proficiency with Microsoft 365 Software and use of systems
• Excellent verbal and written communication skills; strong interpersonal, organizational, time-management and problem-solving skills; and ability to collaborate and interact with all levels within and outside PPSP
• Focus on detail orientation with commitment to prompt, accurate customer service 
• Ability to handle confidential materials that relate to a variety of individuals, to perform well under stress and in a fast-paced environment and to work independently. 
• Ability to handle several projects/tasks simultaneously, 
• Must be able to travel to PPSP locations throughout four-county service area 
• Demonstrated dedication to Planned Parenthoods’ mission, vision and values

PREFERRED:

• Planned Parenthood experience strongly preferred
• Preferred credentials – Epic Credentialed Training Certification in Professional Billing and Claims, Certified Professional Coder

PHYSICAL/MENTAL/COGNITIVE REQUIREMENTS:

• Ability to sit for extended periods of time while working at a computer or desk.
• Manual dexterity for typing, filing and handling office equipment such as telephones and copiers.
• Occasional lifting, carrying, or moving objects up to 15 pounds.
• Visual acuity for reading documents, data entry, and viewing a computer screen.
• Ability to focus and maintain attention to detail in a fast-paced environment with frequent interruptions.
• Strong organizational and time management skills to handle multiple tasks and meet deadlines.
• Critical thinking skills for problem solving, data accuracy, and handling inquires.
• Effective communication skills, both written and verbal, for interacting with coworkers, management, and external clients.
• Ability to follow instructions, adhere to company policies, and handle confidential information with discretion.