Revenue Cycle Manager (RCM)

Pediatric Associates of Dallas is a dynamic Independent Physician owned pediatric medical practice with over 50 years in business. We are the premier provider of pediatric care in Dallas and Collin County. Our organization continues to grow and we are looking for individuals who share our mission, vision and values.

The Revenue Cycle Manager (RCM) is responsible for planning and directing the work of the business office. This position works closely with the Chief Operating Officer (COO) and the Director of Operations (DOO) to establish policies, procedures, deadlines and goals for revenue collection process and staff. They are also responsible for ensuring proper staffing levels in order to provide customer service and meet established deadlines. Additionally, they have oversight of billing and collection teams, ensuring that tasks are completed in a manner that allows for timely revenue collections.

Essential Duties and Responsibilities

The RCM is responsible for (1) overseeing the revenue cycle management process (2) analysis and communication of departmental functions and performance (3) directing patient service and support and (4) leadership for team members.

The RCM will establish a written vision for the business office department. The vision will be updated yearly, shared with leadership and the business office team, and used to guide the strategic objections and decision making of the department.

RCM Daily Operations

• Maximize revenues from service fees and billings. Identifying deficiencies in revenue cycle management and implementing changes as needed.
• Manage billing and accounts receivable systems to operate successfully and efficiently including maximizing automation where possible.
• Maintain compliance with all insurance rules and regulations via monitoring and translating Payer Alerts,

Provider Manuals, payer websites and other resources for updates or changes to clinical requirements or billing processes. This includes, but is not limited to clinical guidelines, billing requirements, and filing deadlines.

• Monitor and audit the contractual compliance of claims payments, identifying and correcting any fee schedule errors or misinterpretations.
• Coordinate the performance of routine audits to assure charge capture is accurate and reflects services provided.
• Ensures accurate and timely month-end, quarter-end, and year-end close processes.
• Manages all aspects of workers compensation program.
• Maintain agreed upon metrics.

RCM Communication and Education

• Create and maintain a monthly KPI dashboard including benchmarks to assess current revenue cycle performance.
• In conjunction with COO, perform yearly revenue projections by company taking into account known payer contract changes and projected growth.
• Initiate and lead meetings to present analysis and suggested changes of RCM to influence and facilitate decision making for improved strategies and tactics.
• Organize at least two physician coding education seminars each year to help maximize billable charges and assure compliance with laws, rules and policies.

RCM Service and Support

• Respond to third party payers, management, staff and patients in day-to-day customer service relations and assist with problem resolution escalating unresolved claims or billing issues as needed to the COO or DOO.
• Coordinate with front desk teams to maintain a thorough and complete patient check in process.
• Maintain patient facing revenue cycle processes that educates and respects all patients at all times.
• Acts as a subject matter expert for escalated issues arising with patients and/or insurance carriers. Assists teams in resolving these issues and keeps COO apprised of problems requiring policy and/or procedural changes on a global level.

RCM Department Leadership

• Maintain and support a culture of ethics, compliance and integrity.
• Develop, monitor and communicate performance metrics for team members.
• Perform performance reviews regularly providing productive feedback and development of growth plans for team members to improve skills and competencies to empower staff to grow to their full potential.
• Monitor team member work product for accuracy, timeliness and completeness.
• Take appropriate corrective actions as needed; prepare and plan workload and successfully manage department responsibilities.
• Present best practice research and education to staff on items including but not limited to root causes of claims denials, underpayments and proven best practices in denials recovery and improved revenue cycle processes.
• Coordinate training internally or through external seminars to ensure that staff is current on coding, billing and collections regulations.
• Maintain and execute a personal growth plan attending meetings, seminars and/or conferences as needed to maintain a current understanding of the industry.
• Addresses issues involving other departments with the respective department leaders for resolution.

Requirements

• Bachelor’s degree OR Certified Medical Coder with relevant experience required.
• Five or more years’ experience in the insurance or medical industry or equivalent experience in a business/accounting department with management and collection experience preferred. Additional education may be substituted for experience.
• Ability to travel between all OCR locations.

Core Competencies

• Leadership – Exhibits confidence in self and others; inspires and motivates others to perform well; effectively influences actions and opinions of others; accepts feedback from others; gives appropriate recognition to others.
• Business Acumen – Understands business implications of decisions; displays orientation to profitability; demonstrates knowledge of market and competition; aligns work with strategic goals.
• Strategic Thinking – Develops strategies to achieve organizational goals; understands organization’s strengths and weaknesses; analyzes market and competition; identifies external threats and opportunities; adapts strategy to changing conditions.
• Change Management – Develops workable implementation plans; communicates changes effectively; builds commitment and overcomes resistance; prepares and supports those affected by change; monitors transition and evaluates results.
• Planning/Organizing – Prioritizes and plans work activities; uses time efficiently; plans for additional resources; sets goals and objectives; organizes or schedules other people and their tasks; develops realistic action plans.
• Conflict Resolution – Encourages open communications; confronts difficult situations; maintains objectivity; keeps emotions under control; uses negotiation skills to resolve conflicts.
• Oral and Written Communication – Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; writes clearly and informatively; edits work for spelling and grammar; able to read and interpret written information; ability to communicate with clients or customers.

• Reasoning and Problem Solving – Uses logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems; identifies complex problems and reviews related information to develop and evaluate options and implement solutions.
• Confidentiality – Excellent interpersonal skills with the ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy. Adheres to HIPAA guidelines.

Supervisory Expectations

Directly supervises five or more employees. Carries out supervisory responsibilities in accordance with the organization’s policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

Benefits

• Medical, Dental, Vision coverage
• Life and AD&D Insurance
• Short Term and Long Term Disability Insurance
• Retirement savings 100% funded by employer
• Employee Assistance Program
• Continuing Education
• Paid Time Off

*Benefit eligibility is dependent on employment status, and a waiting period may apply.

Pediatric Associates of Dallas (PAD) is an Equal Opportunity Employer and prohibits discrimination or harassment

of any kind. PAD is committed to the principle of equal employment opportunity for all employees and to providing

employees with a work environment free of discrimination and harassment. All employment decisions are based on

business needs, job requirements and individual experience and qualifications, without regard to a person’s race,

color, age, sex, gender identity, gender expression, marital status, sexual orientation, religion, creed, national origin,

the presence of any physical or mental disability, or status as a disabled veteran, recently separated veteran, other

protected veteran, or Armed Forces service medal veteran, or any other protected status.

Job Type: Full-time

Pay: From $90,000.00 per year

Benefits:

• Dental insurance
• Disability insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Supplemental pay types:

• Bonus opportunities

Ability to commute/relocate:

• Dallas, TX 75230: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Medical billing: 1 year (Preferred)

Work Location: In person

Please send resume to vdenton@pad-dallas.com