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Revenue Cycle Manager

Revenue Cycle Manager—Full time exempt position
Poughkeepsie, NY

Planned Parenthood Mid-Hudson Valley has an opening for a Revenue Cycle Manager. This full-time, exempt position is responsible for all billing of patient services across the affiliate.  This is a complicated and involved position that must adhere to various government and payer regulations as well as Title X grant and Article 28 regulations. The ideal candidate must have an in-depth knowledge of insurance claims processing procedures, Medicare and Medicaid rules and regulations, patient privacy laws and rights, and debt collection laws and rules. This individual must also be familiar with medical terminology, medical coding, and medical databases.  The Revenue Cycle Manager is responsible for designing, implementing, auditing, and enforcing policies and procedures, as well as streamlining effective billing processes and financial issues.

With the direction from the Director of Revenue Cycle and the CFO, this position is responsible for leading and planning the billing operations and educating the clinical staff with revenue cycle related functions. This position is a member of the Revenue Cycle Committee, Corporate Compliance Committee and Risk Management Committee, and supports Health Information Management by conducting ongoing audits and monitors coding, billing and documentation practices to assure accuracy, accountability and compliance with PPMHV policies and governmental regulations.

Essential Functions:

  • Leads the development of innovative and effective tools to facilitate revenue capture and collections.
  • Researches and analyzes audit data to identify trends and make recommendations corrective actions throughout the affiliate; report findings to appropriate corporate committee
  • Coordinates the billing functions, and works with the billing vendor to ensure timely and accurate bills are submitted to the insurance carriers.
  • Presents findings to appropriate health center and program managers and works collaboratively to educate and train employees with corrective actions.
  • Provides training and/or direction to medical and clerical users of the practice management system.
  • Monitors performance, sets goals and accountability of billing, collections, and applicable consulting agencies.
  • Identifies and trends problems within medical documentation and recommends solutions and provide education and training for corrective actions.
  • Prepares and presents formal and informal instructions to health center personnel.
  • Ensures providers are credentialed with all participating commercial payers

 Experience, Education and Licensure

  • Independent judgment in investigation and preparation of documents.
  • Working knowledge of information systems and technology in healthcare.
  • Proficiency in Microsoft Word, Excel and Power Point
  • Associates degree required, Bachelor’s degree preferred
  • Minimum of 3 years management experience required
  • Minimum of 5 years billing experience in a medical environment required; 1 year plus in a GYN environment preferred
  • Previous training experience required
  • Medical billing and coding certification preferred
  • Own transportation is required, with a valid driver’s license, inspection, registration and insurance. Travel to other locations as needed.

If you believe that you have the experience and qualifications for this position, and would like to be considered, please email an Internal Application (attached), an updated resume and a cover letter to [email protected].

Planned Parenthood® Mid-Hudson Valley is an equal opportunity employer.

Women, people of color, and LGBTQ people are encouraged to apply.