Revenue Cycle Optimization Manager

The Revenue Cycle Optimization Manager provides leadership oversight and strategic direction for revenue cycle operations across Health Services. The position is responsible for ensuring accurate timely compliant and efficient processes throughout the revenue cycle including patient registration and eligibility provider and payer enrollment support charge capture coding claim submission payment posting denial and appeal management accounts receivable patient billing and collections reimbursement monitoring and revenue cycle reporting.

The Revenue Cycle Optimization Manager provides direct leadership and supervision to assigned revenue cycle staff and establishes performance expectations operational standards internal controls and improvement priorities that strengthen financial performance and support sustainable service delivery. The position monitors revenue cycle performance identifies trends and root causes affecting reimbursement and leads cross-functional improvement efforts with clinical operations patient access providers Finance Compliance Health Information Management Information Technology and other Health Services teams.

The position serves as the organizational subject matter expert for revenue cycle business systems and reimbursement workflows including the electronic health record and applicable payer systems. The Revenue Cycle Optimization Manager ensures systems workflows fee schedules payer configurations and billing processes are appropriately maintained and aligned with payer requirements regulatory standards contractual obligations and organizational policies.

The Revenue Cycle Optimization Manager provides specialized leadership for the unique reimbursement and billing requirements of Federally Qualified Health Centers CFAA revenue and other Health Services programs. This includes oversight of applicable Medicare and Medicaid FQHC reimbursement methodologies alternative payment arrangements supplemental payment processes fee schedules and operational implementation of the Health Center Program Sliding Fee Discount Program and billing and collections requirements.

MINIMUM QUALIFICATIONS

The following minimum qualifications are required for this position:

• Bachelors degree from an accredited college or university in Healthcare Administration Business Administration Health Information Management Health Informatics Finance Accounting Public Administration or a closely related field required.

• Five (5) years of professional experience in healthcare revenue cycle healthcare finance reimbursement billing operations healthcare business systems or a closely related area including at least three (3) years of management or supervisory experience.
  • Please note: Supervisory experience includes the authority to hire terminate assign reward and discipline other employees.
• An equivalent combination of education training and experience that demonstrates the required knowledge skills and abilities may be considered.

• Criminal Records Check

• Healthcare revenue cycle operations including registration eligibility charge capture coding billing claims processing payment posting denials appeals accounts receivable and collections.
• Medicare Medicaid commercial payer and managed care reimbursement requirements.
• Healthcare coding and billing principles including ICD-10 CPT HCPCS modifiers claim forms and payer-specific billing requirements.
• Electronic Health Records and healthcare revenue cycle information systems.
• Revenue cycle performance indicators and methods for monitoring and improving financial performance.
• Payer enrollment credentialing interfaces reimbursement configuration fee schedules and payer contract implementation.
• Healthcare regulatory and compliance requirements affecting billing and reimbursement.
• Principles of operational improvement project management root cause analysis and process redesign.
• Budgeting forecasting revenue analysis and financial performance measurement.
• FQHC reimbursement models including Medicare FQHC PPS and Medicaid FQHC payment methodologies.
• Health Center Program requirements related to fee schedules Sliding Fee Discount Programs billing and collections and patient financial responsibility.
• Alternative payment methodologies supplemental payment processes managed care reimbursement and value-based payment arrangements applicable to safety-net healthcare organizations.
• Principles of revenue integrity reimbursement reconciliation payment variance analysis and prevention of revenue leakage.

• Federally Qualified Health Centers (FQHCs)
  Community Mental Health Programs (CMHPs)
  Public Health
  County or local government healthcare systems
  EPIC/OCHIN revenue cycle systems
  Medicare and Medicaid billing and reimbursement
  Managed care or Coordinated Care Organization reimbursement
  Revenue cycle management in a multi-site healthcare organization
  Denial prevention and accounts receivable improvement
  Payer enrollment and reimbursement configuration
  Healthcare financial analysis and forecasting
  Value-based or alternative payment arrangements
  FQHC PPS Medicaid alternative payment methodologies and supplemental/wraparound payment reconciliation
  HRSA Health Center Program billing collections fee schedule and Sliding Fee Discount Program requirements
  Revenue cycle audit readiness and implementation of corrective action plans

• 11 Paid Holidays 64 Personal Leave Hours 2 Floating Holidays 8 hours of vacation accrual every month sick leave! Vacation accrual increases with years of service.

• Medical Dental and Vision -cover your eligible family members without additional premium.
• In addition the County contributes up to $1400 per year to your Health Savings or Health Reimbursement account!
  • Apart from your deductible you can use this money for things that arent traditionally paid by insurance i.e. Ibuprofen Tylenol and other preventative type medications.
  • You never lose your Health Savings Account funds as it rolls over from year to year.
• Dependents up to age 26 are covered!

• After 6 months of employment:
  • The County makes a retirement contribution of 6% of your salary towards Oregon PERS!
  • The County makes a deferred compensation 457b plan contribution of 3% of your salary! You can add more if you wish.

• Interactive and personalized approach focused on your whole health.
• Onsite and virtual seminars wellness challenges and fun activities.
• Monetary incentives and cool prizes to engage everyone and meet your individual needs!

• Supplemental plans are available at reasonable rates.

• This is a FLSA exempt position.
• Please save a copy of this job announcement for your reference as it may not be available for you to view after the job closes.
• Eligible veterans who meet the qualifications will be given veterans preference.
  • For further information please see the following website: Veterans Resources.
  • NOTE:If claiming veterans preference please be sure to attach your DD214 and Disability letter (if applicable) from the VA.
• Benton County does not offer VISA sponsorships. Within three days of hire you will be required to complete the US Department of Homeland Securitys I-9 form confirming authorization to work in the United States. Benton County will review these documents to confirm that you are authorized to work in the United States.
• If you wish to identify yourself as an individual with a disability under the Americans with Disabilities Act of 1990 and will be requesting accommodation please contact the Benton County Human Resources Department by calling .