Case Manager- Western
4534 S. Western Ave.
Chicago 60651
Healthcare Alternative Systems, Inc. (H.A.S.) is a 501 (c) 3 non-profit organization providing behavioral health services to Chicago and the surrounding communities. We offer a continuum of programs addressing substance abuse, mental health, adolescent issues, family relationships, and more. Every year, H.A.S. serves over six thousand individuals.
Benefits:
- Competitive hourly salary
- Health insurance (PPO, HMO)
- Paid time off
- Dental insurance
- Vision insurance
- Flexible spending account (FSA) / Health savings account (HSA)
- Life insurance- Paid by H.A.S.
- Short Term Disability - Paid by H.A.S.
- Long Term Disability - Paid by H.A.S.
- CEU eligible on-site trainings
- Supervision
- $200 Professional Development
ESSENTIAL FUNCTIONS:
The Revenue Cycle Manager is responsible for overseeing revenue cycle management including coding, billing, collections, and denial management as well as financial reporting within the organization. This position is responsible for ensuring claims, denials, and appeals are efficiently processed, and resolving billing-related issues. The Revenue Cycle Manager will minimize bad debt, improve cash flow, and effectively manage accounts receivables. This role will also manage Provider credentialing. The Revenue Cycle Manager will be the main contact for the EDI vendor, Payer contacts, and Clearing House vendor. This position is to stay apprised of coding and revenue trends; and is responsible for coding education billing staff. In addition, this position will manage all Revenue Cycle Management staff; this will include day to day supervision as well as development opportunities, training, and mentorship.
RESPONSIBILITIES:
- Oversee and manage entire revenue cycle including billing, coding, collections, and denial management to DHS SUPR, Medicaid, MCO and Commercial insurance
- Manage relationships with external vendors for practice management software and clearinghouse vendor
- Communicate professionally with various payers and provider representatives
- Manage, develop, and mentor all revenue department staff,
- Responsible for management and maintenance of billing and practice management software platform
- Provide up to date education staff on coding trends
- Develops, evaluates, implements, and revises policies and procedures related to billing, coding, reimbursement activities and improvement strategies
- Reconcile all receivables and revenue reports and work closely with the finance department in the development of the monthly financial statements
- Manage and update the EHR support staff on the current CMS/HFS fee schedule and negotiated contracts
- Conduct monthly analysis of Medicare/Medicaid/Third Party Payers
- Oversees the processing of credentialing and provider enrollment applications, initial, and re-enrollment status with all Medicaid, Medicare, and Commercial Payors
- Responsible for the generation and management of revenue reports
- Review and resolve issues related to claim generation and rejected/denied billings
- Commit to highest level of business and patient confidentiality possible adhering to all HIPAA and security guidelines when accessing and sharing patient information
- Keeps abreast of all reimbursement billing procedures of third party and private insurance payers and government regulations
- Maintains appropriate internal controls over accounts receivable, RCM process
- Monitors accounts sent for collection and reimbursements from insurance companies and other third-party payers
- Reviews, monitors, and evaluates third party reimbursement and researches variances
- All other duties as assigned
QUALIFICATIONS:
- A bachelor’s degree and 3-5 years of related work experience
- Knowledge of third-party payer requirements including federal, state, and private health care plans and authorization process
- Proven experience in healthcare billing, including DHS SUPR, Medicare, Medicaid, MCO and Commercial Insurance
- Knowledge of basic insurance policies, authorizations, procedures, and reimbursement practices with and coding
- Experience with credentialing/re-credentialing of Facilities
- Experience supervising staff
- Prior experience with process development and execution
- Excellent communication and interpersonal skills
- Expert in Microsoft Excel and Word
- Bilingual is a plus
- H.A.S. requires all staff to work on site
EOE