Introduction
To heal, to teach, to discover and to advance the health of the communities we serve.
To learn more about the “Montefiore Difference” – who we are at Montefiore and all that we have to offer our associates, please click here.
Overview
The Revenue Cycle (Revenue Realization) Manager manages and oversees all functions of the output and quality of all payer accounts receivable under their scope and collaborates with the Director of Revenue Realization to identify strategies for performance improvement on a monthly as well as yearly basis. The manager is also responsible to maximize cash flow while maintaining and improving internal and external customer relations. In conjunction with other duties, the payor manager will contribute to the day-to-day operations on all issues related to the revenue cycle functions, provide analysis, create written processes and train others in implementing a cross-functional revenue realization team.
The Payor Manager will also work interdependently with other departments to create reports regularly, and complete other duties as assigned. The Payer Manager is ultimately responsible for much of MMC's financial health as the staff he/she supervises, and their associated functions play a large role in reimbursement and cash flow.
Responsibilities
- Implement a system to ensure that accounts are followed up on a consistent basis based on the follow-up guidelines set in the HIS system.
- Manage the Revenue Realization associates in various duties, such as account management, communications with insurance providers, collections, adhere to payor guidelines, daily accounts receivable monitoring for payors who are trending low, and contract analysis.
- Managing staff performance by providing regular feedback, performance reviews, and one-on-one meetings.
- Reviewing financial hardship applications.
- Overseeing the on-boarding and training of staff.
- Efficiently managing customer needs in respect of billing and collections.
- Planning and structuring the department workflow and staffing.
- Manages RR team operations including all aspects of follow-up, payor communications, underpayment, denials, collections, and payment.
- Supervises and develops RR team members.
- Responsibilities include work allocation, training, and problem resolution; evaluating performance and making recommendations for action; motivating employees to achieve peak productivity and performance.
- Serves as the resident expert and "go to" person for all accounts receivable, denials and collections processes.
- Develops, reviews, and enhances operating policies and procedures to improve quality and efficiency.
- Analyzes actionable claims data, including revenue and volume, by service line, and payor.
- Ensures compliance with collections and billing regulations, relevant healthcare regulations and data privacy issues (e.g., HIPAA).
- Coordinates team member paid time off (PTO) in a manner that does not negatively impact necessary daily functions.
- Prepares and reviews periodic reports of performance metrics with the Revenue Realization director.
- Performs other miscellaneous job-related duties as assigned.
Requirements
- Minimum of a Bachelor's Degree required, Master's preferred.
