Manager revenue cycle operations - usftgp umsa rco back end

The Manager of Revenue Cycle, Revenue Cycle Operations (RCO), USFTGP, provides leadership, oversight and direction for all professional services provided by the Tampa General Physicians Group including generating RCO performance and benchmark summaries, conducting high-level problem solving with a focus on compliance and revenue optimization, addressing systemic root causes of chronically recurring problems, serving as the primary point of contact between TGMG for account specific billing issues, and functioning as next level of issue escalation for revenue cycle staff.

Essential Functions

• Works with management staff of TGMG to identify opportunities for improvement and assist in resolution of fiscal issues related to or involving Revenue Cycle Operations.
• Serves as a resource for clinical providers and departmental staff in providing and assisting in interpretation of fiscal data related to revenue generated, reimbursement received and managed care issues that impact these areas.
• Responsible for generating or overseeing the creation of RCO benchmark and financial reports, spreadsheets for analysis and other necessary reports to track trends or areas that require corrective action or identify opportunities for revenue optimization.
• Prioritizes reports that that will be provided to the Senior Director, RCO and presented to Department Chairs, Division Chiefs and clinical departments as necessary.
• Makes recommendations for action to be taken when problem areas are identified.
• Establishes aggressive, but realistic goals and objectives to monitor workflow and implement revisions as necessary to ensure all revenue cycle processes are performed professionally, accurately and with a focus on customer service.
• Meets with physicians and clinical department staff to keep them informed of reimbursement issues as it relates to collections, front-end denials and any other front-end revenue cycle process that impacts departmental revenue.
• Identifies and establishes rules and methods to eliminate denials through a proactive approach to revenue management by correcting errors before they can be denied by the payers.
• Guides individuals and groups toward desired outcomes through the establishment of goals/metrics, setting high-performance standards, and communicating the impact of each employee’s work on team success.
• Motivates and inspires others to work toward communicated goals.
• Fosters an environment of trust among team members by encouraging employees to work together to accomplish goals.
• Identifies and establishes rules and methods to eliminate denials through a proactive approach to revenue management by correcting errors before they can be denied by the payers.
• Employs system level and process improvement approach considering the long-term impact of decisions and recommendations.
• Weighs fiscal responsibility when making decisions.
• Uses sound judgment to make decisions in the face of uncertainty.
• Guides and implements revenue cycle workflow optimization efforts using Epic functionality and related automation technology.

Education

High School Diploma or GED

Work Experience and Additional Information

Five (5)+ years experience in healthcare professional billing and/or follow-up functions. Experience in Epic Professional Billing (PB) system support, including configuration, troubleshooting, and optimization. Strong skills in data analytics, workflow redesign, and change management within complex healthcare environments. Demonstrated ability to lead cross-functional teams, drive operational efficiency, and implement sustainable improvements that enhance financial performance and patient outcomes. A major emphasis on knowledge of multispecialty practice billing and collection operations in an academic setting is required. Must possess knowledge of multispecialty practice billing and collection operations in an academic setting.

Technical Knowledge, Skills, and Abilities

• Excellent communication skills, with ability to present to varying levels of leadership and staff.
• Intermediate computer skills (Word, Excel, Power Point, Database, Reporting).
• Intermediate writing skills.
• Ability to provide excellent customer service.
• Knowledge of HCFA 1500 claim forms, diagnosis and procedure coding terminology.
• Ability to multi-task, plan and track progress.
• Comprehensive knowledge of principles and practices of medical group organizations, and management in revenue cycle management.
• Proficiency in healthcare IT systems related to patient access and revenue cycle management.