Job Description

POSITION TITLE: Revenue Cycle Manager

FLSA STATUS: Exempt, Full-Time

S TO: Director of Accounting

SUPERVISES: Managed Care Coordinators

DEPARTMENT: Finance and Accounting

COMPANY: MHS/The Overlook – Charlton Campus

POSITION SUMMARY:

The Revenue Cycle Manager is responsible for managing eligibility, authorization, and billing operations for Overlook’s Home Care and Hospice divisions. This position will provide management and direction to the following functions including insurance verification, authorization, billing, collection, and cash posting to achieve optimal results.

The Revenue Cycle Manager will be responsible for ensuring these functions increase optimization, maximize cash flow, lower denials, and write-offs, and encourage the team to work on the reversal of denials. The manager will be responsible for developing the team on the entire revenue cycle process, implementing policies and procedures in accordance with legal requirements, and in support of company policies.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

The following duties are normal for this position. This list is not to be construed as exclusive or all inclusive. Other duties may be required and assigned.

• Provide clear direction and decision making base on understanding of both financial and clinical elements. Deciding on how to operationalize HCHB or regulatory changes.
• Increase collaboration with other administrative and clinical departments.
• Supports organization’s mission by striving for excellence in all aspects of their job with a focus on positive interpersonal relationship with co-workers, departments, and entity leaders.
• Develops productivity goals of staff and ensures goals are being met monthly by creating and meeting KPIs.
• Extensive knowledge of revenue cycle metrics and drivers, particularly in billing and collections (including days in AR reduction, improved cash collections, reduced aging, lower denials).
• Provides financial trend s in areas of adjustment reasons, denial reasons, resubmitted billings, accounts receivable, held revenue, late or retro charges, etc.
• Prepares and analyzes s for senior management and other management groups.
• Manages AR aging and cash collection to ensure financial targets are met.
• Assists with month-end close processes, s and financial audits.
• Responsible for monitoring workflow of staff and billing process.
• Monitors billed and unbilled claims.
• Directly supervises and supports staff assigned, including performance evals, goal setting, and creating performance improvement plans with People and Culture.
• Focuses on staff development by facilitating and teaching the staff the technical skills necessary to perform activities of accounts receivable.
• Ensures all billing tasks are performed in adherence with CMS regulations and compliance.
• Ensures timely implementation of business procedures.
• Supervises staff in conjunction with the organizations directorial/leadership practices.
• Updates and maintains all payer contracts in billing system.
• Troubleshoots payer issues and identified trends.
• Manage the daily operations of the home health/hospice insurance verification, authorization, billing, collection and cash posting.
• Provide leadership with insightful and action-oriented solutions.
• Ensure prompt insurance verification and authorization.
• Appropriate management of all billing and collection functions to reduce the overall level of outstanding AR.
• Provide operational solutions to Central Billing Office staff.
• Implement and train Central Billing Office staff on new departmental policies and procedures.
• Work to reduce the level of AR write-offs and bad debts.
• Support the PFS Director with Central Billing Office operations.
• Other duties and responsibilities as assigned by the Director of Accounting.

POSITION REQUIREMENTS:

• Minimum of a Bachelor’s Degree in Business Administration, Finance, Accounting and other related field
• Minimum of 3 years leading teams of people in a management role in a healthcare setting
• Minimum of 5 years working with billing claims, denials, and insurance authorizations for commercial payers, Medicare, and Medicaid
• Home Health/Hospice experience – required
• Prior experience with HomeCare HomeBase – preferred
• Highly organized with the capacity to manage work and priorities autonomously
• Advanced knowledge of PowerPoint, Publisher, Excel, Word, Outlook Email and Calendar
• Must be “hands-on”, roll up your sleeves, meet deadlines, and bring projects over the finish line in order for the organization to succeed
• Must be self-reflective, open to feedback, and speak transparently
• Ability to maintain sensitive information and confidential data
• Alignment with The Overlook’s Guiding Principles

PHYSICAL REQUIREMENTS/WORKING CONDITIONS:

Primary work will be performed indoors in an office setting, may be exposed to the elements (heat, cold, rain, snow); walking and standing frequently; occasional lifting of up to 35 pounds.

COMMUNITY OVERVIEW:

The Overlook is a non-profit organization operating since 1911 and offering a full continuum of care and services for older adults in MA. The organization embraces its rich history and heritage, owning and managing 218 Independent Living Apartment Homes and Cottages, 28 Enhanced Care Private Suites, a 14- Suite Assisted Living Memory Care neighborhood, 27-unit Short-term Post-Acute Rehabilitation, 112-bed Long Term Care Skilled Nursing, as well as Home Health, Hospice, Palliative Care, Private Duty and Care Management divisions.

The Overlook and its 3 subsidiaries are based in Charlton, MA, with satellite home health and hospice offices across the state. The organization employs approximately 600 talented and compassionate Team Members and serves 1,500+ Residents/Patients.

The Overlook has a Vision to design a mixed-use Community beyond its singular function as a Retirement Community, a pedestrian-friendly, walkable “Village Center” environment, with select retailers, restaurants featuring fresh, locally sourced food, a brewery, a large banquet, and events center, enriching programs, health and wellness-focused on mind, body and spirit, and more. The Overlook’s bucolic setting on 450 acres of beautiful New England countryside, 16 miles of nature trails, a dog park, and a wealth of amenities offer limitless possibilities in helping us reposition our Campus.

THE OVERLOOK WAY:

All Team Members of The Overlook must embrace and commit to conducting themselves at all times in support of our 28 Guiding Principles, Culture of Excellence, and core values, which form the foundation of our unique culture. The Overlook strives to exceed expectations, inspire and “Do what’s best for those we serve.”

• 
  Integrity: saying what you mean, meaning what you say (in action and words), even if it hurts you personally or professionally
• 
  Respect for Individual Choice: empowering and supporting others in their Self-determination for health and well-being, as they define it
• 
  Compassion: understanding and empathy for others
• 
  Creativity/Innovation: thinking wildly, planning accordingly
• 
  Grace: putting people at ease, without compromising performance or outcomes

JUST SOME OF OUR BENEFITS AND PERKS:

In compliance with the Americans with Disabilities Act, The Overlook will provide reasonable accommodations to qualified individuals with disabilities and encourages prospective Team Members and incumbents to discuss potential accommodations with the employer. The Overlook is strongly committed to diversity and a workplace environment that respects, appreciates, and values employee differences and similarities. By providing and supporting a work culture that fosters and builds upon diversity and its strengths, The Overlook will better serve our communities. The Overlook is an employment-at-will organization and an equal opportunity employer committed to maintaining a work and learning environment free from discrimination on the basis of sex, race, color, religion, national origin, pregnancy, gender identity, sexual orientation, marital/civil union status, ancestry, place of birth, age, citizenship status, veteran status, political affiliation, genetic information or disability, as defined and required by state and federal laws. Additionally, The Overlook prohibits retaliation against an applicant or employee because he or she has engaged in protected activity under the statutes prohibiting discrimination in the workplace.

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COMMUNITY OVERVIEW:

The Overlook is a non-profit organization operating since 1911 and offering a full continuum of care and services for older adults in MA. The organization embraces its rich history and heritage, owning and managing 218 Independent Living Apartment Homes and Cottages, 28 Enhanced Care Private Suites, a 14- Suite Assisted Living Memory Care neighborhood, 27-unit Short-term Post-Acute Rehabilitation, 112-bed Long Term Care Skilled Nursing, as well as Home Health, Hospice, Palliative Care, Private Duty and Care Management divisions.

The Overlook and its 3 subsidiaries are based in Charlton, MA, with satellite home health and hospice offices across the state. The organization employs approximately 600 talented and compassionate Team Members and serves 1,500+ Residents/Patients.

The Overlook has a Vision to design a mixed-use Community beyond its singular function as a Retirement Community, a pedestrian-friendly, walkable “Village Center” environment, with select retailers, restaurants featuring fresh, locally sourced food, a brewery, a large banquet, and events center, enriching programs, health and wellness-focused on mind, body and spirit, and more. The Overlook’s bucolic setting on 450 acres of beautiful New England countryside, 16 miles of nature trails, a dog park, and a wealth of amenities offer limitless possibilities in helping us reposition our Campus.

THE OVERLOOK WAY:

All Team Members of The Overlook must embrace and commit to conducting themselves at all times in support of our 28 Guiding Principles, Culture of Excellence, and core values, which form the foundation of our unique culture. The Overlook strives to exceed expectations, inspire and “Do what’s best for those we serve.”

Integrity: saying what you mean, meaning what you say (in action and words), even if it hurts you personally or professionally

Respect for Individual Choice: empowering and supporting others in their Self-determination for health and well-being, as they define it

Compassion: understanding and empathy for others

Creativity/Innovation: thinking wildly, planning accordingly

Grace: putting people at ease, without compromising performance or outcomes

JUST SOME OF OUR BENEFITS AND PERKS:

In compliance with the Americans with Disabilities Act, The Overlook will provide reasonable accommodations to qualified individuals with disabilities and encourages prospective Team Members and incumbents to discuss potential accommodations with the employer. The Overlook is strongly committed to diversity and a workplace environment that respects, appreciates, and values employee differences and similarities. By providing and supporting a work culture that fosters and builds upon diversity and its strengths, The Overlook will better serve our communities. The Overlook is an employment-at-will organization and an equal opportunity employer committed to maintaining a work and learning environment free from discrimination on the basis of sex, race, color, religion, national origin, pregnancy, gender identity, sexual orientation, marital/civil union status, ancestry, place of birth, age, citizenship status, veteran status, political affiliation, genetic information or disability, as defined and required by state and federal laws. Additionally, The Overlook prohibits retaliation against an applicant or employee because he or she has engaged in protected activity under the statutes prohibiting discrimination in the workplace.

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