JOB SUMMARY

The position will be responsible for managing and overseeing four primary areas, which includes: billing revenue collections, utilization management, credentialing and managing front desk staff for the agency.

DUTIES AND RESPONSIBILITIES

• Oversees all aspects of revenue cycle management processes; interacts with leadership, directors, and all members of the Revenue Cycle Team within the agency.
• Conducts weekly meetings to update potential issues to the revenue cycle team, and a monthly meeting including the leadership team.
• Assists in evaluating current and proposed systems and procedures for staff.

• Serves as a liaison between clinical center directors and revenue cycle management.
• Support the revenue cycle team by assisting with issues, potential problems, and resolving them with well thought-out decisions.

• Monitors Authorization and eligibility review functions to ensure sites are maintaining KPIs
• Interviewing, hiring, training, and disciplining staff.
• Completing annual evaluations and goals for front desk staff.
• Reviews and updates forms used within the revenue cycle management; standardizes when possible.

• Determines best approach to dealing with managed care plans and over the counter collections for those plans as well as self-pay patients. Complies with contractual terms agreed to by contract.
• Knowledge of legal issues in all aspects of operations to ensure compliance with regulatory agencies and rights of all customers.
• Develops and implements policies and procedures to meet state and federal regulations.
• Develops, monitors and analyzes budget and financial information and utilizes all resources in an effective and economical manner.
• Works with the chief financial officer to ensure all revenue collections and reporting.
• Knowledgeable of Medicare, Medicaid, managed care, and other third-party payor's guidelines.

• Ensure proper authorization for all clinical services provided and assist program managers in ensuring proper level of care is routinely provided.
  • Assist agency leadership in achieving and maintaining regulatory standards of external stakeholders and Commission on Accreditation of Rehabilitation Facilities (CARF) accreditation as it pertains to UM

• Interpret utilization management and quality assurance guidelines. Create/modify internal guidelines as needed
• Maintain knowledge of current trends and developments

SKILL, COMPETENCY AND EDUCATION AND/OR LICENSURE REQUIREMENTS

• Bachelor’s degree in a related field, and
• 4-8 years of experience in a management level revenue cycle role, or
• A combination or education and relevant experience

INTER-RELATIONSHIPS

Works and communicates with the general public, internal customers, and/or external customers to provide information and quality services to meet customer expectations.

WORKING CONDITIONS

No unusual working conditions. Normal work hours

NEEDED ATTRIBUTES

Possess advanced skill levels. Must be able to display a high level of effort and commitment to performing work; operate effectively within the organizational structure.

Demonstrate trustworthiness and responsible behavior; Show persistence and initiative.

Pre-employment drug screening may be required. The selected applicant will be subject of an FBI Criminal History Record Check, and the applicant has the right to challenge the contents of their Criminal History Record Information, should they choose to do so. This employer participates in E-Verify.

For more information visit https://claratel.org/

Claratel Behavioral Health is an equal opportunity employer regarding disability under VEVRRA and ADA