Revenue Cycle Manager

Who We Are:

Neighborhood Health Center is a non-profit organization local to Portland, OR serving underserved patients in the areas of primary care, internal medicine, dental services and more. Our patient-centered approach to care honors the unique needs and circumstances of each individual patient. NHC sees people, not problems, and recognizes that the time spent as a patient in a doctors office is only one factor in a persons overall health. Our leading edge, integrated clinical teams work in partnership with patients, their families, and the communities we serve to provide whole-person care, prevention, and ongoing support.

NHC is an Equal Opportunity Employer. We celebrate differences in the workplace and do not discriminate in employment opportunities or practices on the basis of race, color, religion, gender (sex), national origin, age, veteran status, sexual orientation, gender identity, disability, genetic information or any other characteristic protected by law.

Why work with us?

• We are a non-profit organization, passionate about providing the underserved population with medical and dental services across the greater Portland area, committed to making a difference daily.
• We offer our employees a competitive compensation and benefits package which includes 20 days of PTO (based on full time employment), 9 paid holidays, health/dental/vision insurance, quarterly wellness reimbursements, generous 401k retirement plan with employer match, employer paid disability insurance, EAP and life insurance.
• Our employees voted NHC a Top Workplace in 2020, 2021, 2022, and 2023!

Job Title:  Revenue Cycle Manager
Department:  Administrative
Reports To:  Director of Finance
Work Type:  Hybrid
Classification:  Full-Time, Exempt
Language Differential:  Ineligible

SUMMARY

The Revenue Cycle Manager is responsible for fostering the department's development and expansion through various responsibilities. These include identifying organizational requirements, recruiting, training, and overseeing personnel. Additionally, they play a crucial role in advising the Executive Leadership Team on matters pertaining to the revenue cycle, contributing to strategic decision-making. The manager's role is pivotal in driving continual enhancements to critical revenue cycle metrics and optimizing all facets of the billing process. Moreover, they are instrumental in formulating and executing strategies aimed at augmenting revenue streams within the organization.

Essential Job Duties

• Coordinate and support payer contracts by maintaining and updating payer contracts list; implementing contract requirements and troubleshooting revenue issues with provider representatives; reporting on utilization and comparing to practice management (PM) system; implement grant and value-based contracts, ensuring compliance and tracking via the PM system.
• Develop, mentor, manage, and train revenue cycle staff, including timely feedback and annual reviews.
• Coordinate with multiple departments and managers to ensure proper workflows, training, and follow-up for patient intake and revenue capture.
• Collaborate with Epic and OCHIN on JIRA details related to revenue cycle activities.
• Provide support and guidance on coding and documentation issues; feedback to providers on corrections; implementation of new services; managing coding audits and improvement projects; training and coordination with back office and billing staff to correct coding errors.
• Create, implement, and monitor KPIs specific to the revenue cycle function to monitor performance and identify areas for improvement.
• Prepares monthly wrap submissions, quarterly reconciliations, and appeals for PPS reimbursement from OHA.
• Manage APM (Alternative Payment Models) patient enrollment and appeals.
• Oversee the performance of OBS on the billing process, including claims processing, payment posting, denial management, AR follow-up, and patient collections.
• Enrolls providers and facilities with clearinghouse. Oversees credentialing holds in PM system and troubleshoots credentialing denials.
• Collaborate with finance staff projecting types of encounters and net visit revenue during the budget/forecasting process.  Support finance staff with financial reporting by explaining encounters, net visit revenue, and trends/variances in accounts receivable.
• Prepare and update the fee schedule for annual review by executive leadership.
• Collaborate with the EPIC team to manage the fee schedule and preference lists, as well as create and test JIRAs to enhance charge capture and supplement EPIC clinical training.
• Develop and update policies and procedures related to revenue cycle under the guidance of leadership.
• Support FQHC and HRSA compliance within the organization including: the 340B program, VFC (Vaccines for Children), and others.
• Perform other duties as assigned by leadership.

QUALIFICATIONS

Education and/or Experience

• Bachelor’s degree in healthcare administration, business administration, finance or related field is preferred.
• Two years’ revenue cycle management experience is required.
• Four years’ revenue cycle experience, including Medicare and Medicaid billing, is required.
• Experience with the unique regulatory and compliance requirements governing FQHCs, including Medicare and Medicaid billing guidelines, is preferred.
• Experience with Epic electronic health record software is preferred.

License and/or Certification Requirements

• Relevant certifications such as Certified Professional Coder (CPC), Certified Revenue Cycle Professional (CRCP), or Certified Medical Reimbursement Specialist (CMRS) preferred.

Knowledge, Skills, Abilities & Behaviors

• Strong analytical skills to evaluate revenue cycle metrics, identify issues or inefficiencies, and develop solutions to improve financial outcomes.
• Mastery of medical office operations, professional fee billing, reimbursement and third-party payer regulation and medical terminology is required.
• Excellent communication and interpersonal skills to interact effectively with patients, providers, insurance companies, and internal staff.
• Strong problem-solving skills and ability to make timely decisions.
• Ability to work, plan, research and conduct projects with minimal supervision.
• Ability to organize and prioritize workload to manage multiple tasks and meet deadlines.
• Ability to work collaboratively in a team environment and lead revenue cycle improvement initiatives.
• Advanced knowledge of FQHC practices, CMS, Medicaid, payer contracts, and revenue cycle functions.
• Knowledge of HIPAA regulations and patient confidentiality guidelines.
• Demonstrated ability to coordinate and prioritize multiple demands and projects.
• Ability to work with a diverse patient and staff population.

WORKING CONDITIONS

• Regularly sit while working on the computer; use hands and fingers to handle, control or feel objects tools or controls; repeat the same movements when entering data; ability to differentiate between colors, shades, and brightness; read from a computer screen for extended periods of time.
• Frequently stand and walk around the office to gather supplies, required to do filing, use office equipment, or collaborate with employees.
• Occasionally stand, stoop and lift or move objects, equipment and supplies weighing approximately 20-25 pounds up to 40-50 pounds.
• The noise level in the work environment is usually moderate.
• This position will typically work Monday through Friday, 8:00am to 5:00pm, and must be present during core business hours.

Neighborhood Health Center Employment Offers are contingent on successful completion of reference checks, background checks, drug screening for illegal substances, Tuberculosis, and any position specific credentialing or licensure requirements.