Job Description: The Health Care Revenue Cycle Operations Manager serves as the point of communication, coordination, and collaboration between the PBP organization/practices and RCM operations. This includes reviewing, assessing, and optimizing the process and operations concerning registration, pre-authorization, coding, billing, collections, reimbursement, and financial analysis to optimize revenue generation and cash collections and ensure compliance with regulatory requirements. The role requires strong leadership, analytical skills, and a deep understanding of end-to-end HB billing processes. Responsibilities: Revenue Cycle Management: Assess and evaluation the entire revenue cycle process from patient scheduling/registration to final payment or resolution of outstanding balances. Monitor key performance indicators (KPIs) related to revenue cycle operations, identify areas and develop/implement plans for improvement. Develop and implement strategies to improve revenue cycle efficiency, reduce denials, and maximize collections. Collaborate with operational leaders within PGP, RCM, and other divisions of Emory Healthcare to drive PBP RCM performance. Develop strong relationships and collaboration with the providers of PGP and staff. Financial Analysis: Analyze revenue cycle data to identify trends, issues, and opportunities for optimization. Prepare financial reports and presentations for senior management, highlighting key performance metrics and areas for improvement. Technology and Systems Management: Collaborate with IT department to optimize revenue cycle software and ensure seamless integration with other systems. Staff Management: Supervise and mentor staff. Provide training and professional development opportunities to enhance staff skills and knowledge. Compliance and Risk Management: Ensure compliance with all relevant healthcare regulations, including billing and coding guidelines, fraud and abuse laws, and payer requirements. Develop and implement policies and procedures to mitigate revenue cycle risks and ensure adherence to compliance standards. Assist in the monitoring of operations to ensure accurate and compliant billing and coding practices in accordance with regulatory guidelines, such as HIPAA and CMS regulations. Stay updated on changes to billing and coding regulations and advise the organization on necessary changes to maintain compliance.

Minimum Qualifications: Minimum Qualifications: Bachelors Degree in healthcare or a related field with six (6) years healthcare experience, or four (8-10) years revenue cycle experience with, two (2) of which must be supervisory, OR any combination of equivalent education and experience. A demonstrated track record of success in optimizing revenue and reducing denials. In-depth knowledge of healthcare billing, coding, reimbursement, and compliance regulations. Strong analytical and problem-solving skills, with the ability to interpret complex financial data and identify opportunities for improvement. Excellent leadership and interpersonal skills, with the ability to effectively manage a team and collaborate with cross-functional stakeholders. Proficiency in revenue cycle management software and Microsoft Office suite. PHYSICAL REQUIREMENTS (MediumMax 25lbs): up to 25 lbs, 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.

ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock , Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation , Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.