Third Party Revenue Manager

The 3rd Party Revenue Manager is responsible for planning, directing and coordinating the direction and tactics for MNHC’s 3rd party revenue and reimbursement strategy.  This position is responsible for overseeing the activities and operation of the centralized billing and collections staff through daily supervision of the following functions: accounts receivables including the follow up, charge entry, claims submissions, payment posting, denials tracking, medical coding analysis, billing reporting/metrics maintenance and tracking and reimbursement management.  The individual in this position will be a hands-on manager able to coach, train, and evaluate staff’s performance.  She/he will work closely with the CFO to plan and strategize the organizations 3rd party and patient revenue goals.

Essential Functions & Responsibilities:

• Direct Billing Department of the organization to ensure that accurate submission of all claims and timely collections occur in accordance with all third party contract terms including, Medicare, Medi-Cal, managed care, commercial insurance, and direct patient pay.
• Consistently ensure that unprocessed claims and denials are reviewed, reworked, and resubmitted to ensure revenue maximization.
• Maintain all billing and financial data, including medical billing code tables, rate/fee schedules and payer information.
• Analyze reimbursement from all sources, including carrier reimbursement exception.
• Assure maximization of cash collections through diligent and timely monitoring of all open accounts receivable balances.
• Maintain and enhance billing policies and procedures for each function in the revenue cycle process and ensure staff adherence to policies.
• Prepare detailed analyses and reports of billing and accounts receivable activity and results, including performance matrixes, bad debt expense and AR days outstanding on a daily, weekly, monthly basis as determined by the CFO.
• Effectively communicate and provide training on changes in eligibility, insurances, coding updates and coding errors to appropriate staff in the organization.
• Manage for continuous improvements within the revenue cycle process working with the Patient Service Director and CFO.
• Provide mentoring, coaching and performance reviews for direct reports.
• Manage all billing and collection operations, including: orientation, training, development, coaching, corrective actions, and ongoing monitoring of all staff work-related activities.
• Ensure consistent quality of the billing services by distributing and assigning duties and responsibilities to employees, ensuring skill levels are appropriate to the assigned tasks, and monitoring the department’s productivity.
• Develop, implement, and monitor quality control standards to ensure proper billing, coding, and compliance including Medicare and Medi-Cal compliance.
• Coordinate timely month-end Accounts receivable/Billing close in collaboration with the accounting manager.
• Research and address issues/problems constructively, follow through to ensure timely resolution and to improve efficiency, compliance, and revenue maximization.
• Act as leader on implementation of any billing /coding related changes in the organization, i.e.; ICD-10, CPC updates and others as determined by changes in the industry.
• Attend and actively participate in organizational meetings.

Qualifications:

• Bachelor’s degree in accounting, business administration, health care administration/management or related field experience.

• Minimum 5+ years of management experience as a Revenue Cycle/Billing Manager or Revenue Cycle Director in a community health center or medical setting.
• Knowledge of FQHC and or Community Health Center rules and procedures impacting insurance reimbursement, state and Federal billing regulations.
• Knowledge of organizational structure, workflows and operating procedures within a community Health care center billing environment.
• Knowledge of accounting principles and strong technical knowledge of accounts receivable, write off and collection principles.

• Ability to supervise, train and coach others. Excellent written and verbal communication skills. Ability to coordinate multiple projects and follow through to completion.

• Proficiency in Microsoft Office applications: Outlook, Word, Excel, and Internet Explorer and Practice Management Systems.
• Knowledge of CPT codes, prefer a Certified Professional coder (CPC).
• Thorough knowledge of ICD-10 coding protocols and procedures.

• Must be well-versed with all federal, state and HIPPA privacy regulations.

As a condition of employment, all candidates are required to provide documentation of current immunizations before the start date, including COVID-19 and TB test results valid within the last two (2) years. Failure to provide this documentation may result in a delayed start or withdrawal of the job offer.

​​​​​​​To learn more about our organization, please visit our website at www.mnhc.org. We offer a full range of benefits which includes the following:

• Medical Insurance – MNHC pays 90-100% based on plan
• Dental and Vision Insurance – free to employee
• Life Insurance – free basic policy plus voluntary option
• Flexible Spending Accounts for health & dependent care expenses
• Commuter benefits for public transportation expenses
• Vacation – 2 weeks (3 weeks after 5 yrs; 4 weeks after 8 yrs)
• 12 Paid Holidays plus your birthday and 12 Sick Days each year
• 40 hours Paid Educational Leave
• 401k Retirement Savings Plan with Company Contribution

Mission Neighborhood Health Center is an Equal Employment Opportunity employer committed to fostering an inclusive environment for our diverse workforce. We do not discriminate based upon race, religion, color, national origin, sex (including pregnancy, childbirth, reproductive health decisions, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, genetic information, or other applicable legally protected characteristics. Pursuant to the San Francisco Fair Chance Ordinance, we will consider employment for qualified applicants with arrest and conviction records.