Revenue Cycle Operations Manager

Position Summary:

The Revenue Cycle Operations Manager for Patient Financial Services (PFS) will evaluate business processes, anticipate requirements, uncovers areas for improvement, and develop and implement solutions across the department. Additionally, this position will lead the design, development and implementation of best practice guidelines within systems and/or policy and procedures to achieve workflow efficiency across the department. Successful candidates will be able to access and manipulate data, have critical thinking skills and will possess an ability to guide and train PFS staff in the completion of projects across the department.

Job Responsibilities:

• Leads the analysis implementation and maintenance of revenue cycle best practice processes and activities across the department and ensures goal setting and project tracking.

• Develops and monitors staff work queues and productivity to ensure work volumes and staffing are aligned.

• Audits staff work and participates in developing and delivering training programs within the department.

• Creates system and processes audit plans. Resolves discrepancies, as required.

• Troubleshoots issues and resolves concerns, as well as recommends necessary fixes. Advises management of results and recommends actions.

• Prepares data analysis for departmental leadership in organized format to clearly convey trends and identify key areas for revenue optimization.

• Creates reports to evaluate accounts receivables, operational productivity and departmental outcomes.

• Analyzes data trends to determine the root cause and conducts deep dive sampling.

• Provides a detailed assessment of revenue cycle processes with a focus on process improvement and best practices.

• Monitors and tracks ongoing departmental performance through key performance indicators (KPI) in comparison to industry benchmarks.

• Cultivates effective collaborative relationships with departmental teams to seek resolution of issues identified through monthly monitoring of KOIs / KPIs.

• Works closely with Department management to facilitate root issue remediation. Collaborates closely with peers to develop, validate, and maintain meaningful report sets.

• Maintains knowledge of Medicare, Medicaid and Commercial reimbursement. Stays abreast of group payer contracts, payer policies, payer plans, and member benefits. Keeps apprised of rules and regulations affecting reimbursement.  

• Manages special projects and duties as needed, or assigned.

Required Qualifications:

• Bachelor’s degree and 5 years revenue cycle, medical billing or follow-up experience. 
  Or, in lieu of degree, at least 9 years healthcare revenue cycle experience.

• Proficient in MS Office Suite including; Excel, Word, Access, Visio, PowerPoint (Power Query; BI). 

• Knowledge of Invision Patient Accounting, Contract Management and/or Claims Scrubber software.

• Experience reporting from healthcare decision support, patient accounting, contract management and/or claims scrubber systems.

• Knowledge of CPT, HCPCs and ICD-10 coding principles.

• Expert knowledge of inpatient and outpatient billing requirements (UB-04, 837i); specifically how claims information impacts and drives reimbursement.

• Expert knowledge of Medicare, Medicaid and Commercial reimbursement methodologies.

• Intermediate to advanced proficiency in SQL or Database reporting queries.

• Demonstrated analytical skills-ability to break down and quantify problems and processes.

• Excellent written and verbal communication skills.

• Demonstrated ability to manage a process and timelines effectively.

Preferred Qualifications:

• Master’s degree in Accounting or Finance, Health Information Management, Health Administration, Computer Science or related field.

• Medical Coding Certification through the American Academy of Professional Coders (AAPC), and/or the American Health Information Management Association (AHIMA).
• Revenue cycle supervisory or managerial experience.

Please Note\: Verification of degree (e.g., diploma or official transcript) is required for this role. Upload of documentation must be included with your application for consideration.

Special Notes\:   Resume/CV should be included with the online application.

Posting Overview:  This position will remain posted until filled or for a maximum of 90 days. An initial review of all applicants will occur two weeks from the posting date. Candidates are advised on the application that for full consideration, applications must be received before the initial review date (which is within two weeks of the posting date).

If within the initial review no candidate was selected to fill the position posted, additional applications will be considered for the posted position; however, the posting will close once a finalist is identified, and at minimal, two weeks after the initial posting date. Please note, that if no candidate were identified and hired within 90 days from initial posting, the posting would close for review, and possibly reposted at a later date.

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• Stony Brook Medicine is a smoke free environment. Smoking is strictly prohibited anywhere on campus, including parking lots and outdoor areas on the premises.
• All Hospital positions may be subject to changes in pass days and shifts as necessary. 
• This position may require the wearing of respiratory protection, which may prohibit the wearing of facial hair. 
• This function/position may be designated as “essential.” This means that when the Hospital is faced with an institutional emergency, employees in such positions may be required to remain at their work location or to report to work to protect, recover, and continue operations at Stony Brook Medicine, Stony Brook University Hospital and related facilities.

Prior to start date, the selected candidate must meet the following requirements:

• Successfully complete pre-employment physical examination and obtain medical clearance from Stony Brook Medicine's Employee Health Services*.
• Complete electronic reference check with a minimum of three (3) professional references.
• Successfully complete a 4 panel drug screen*.
• Meet Regulatory Requirements for pre-employment screenings.
• Provide a copy of any required New York State license(s)/certificate(s).

Failure to comply with any of the above requirements could result in a delayed start date and/or revocation of the employment offer.

*The hiring department will be responsible for any fee incurred for examination.

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Stony Brook University is committed to excellence in diversity and the creation of an inclusive learning, and working environment. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, pregnancy, familial status, sexual orientation, gender identity or expression, age, disability, genetic information, veteran status and all other protected classes under federal or state laws.

If you need a disability-related accommodation, please call the University Office of Equity and Access at (631)632-6280.

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Stony Brook University Hospital, consistent with our shared core values and our intent to achieve excellence, remains dedicated to supporting healthier and more resilient communities, both locally and globally.

Anticipated Pay Range:

The salary range (or hiring range) for this position is $98,000 - $109,000 / year.

The above salary range represents SBUH’s good faith and reasonable estimate of the range of possible compensation at the time of posting.  The specific salary offer will be based on the candidate’s validated years of comparable experience.  Any efforts to inflate or misrepresent experience are grounds for disqualification from the application process or termination of employment if hired.

Some positions offer annual supplemental pay such as:

• Location Pay for UUP full-time positions ($4,000)

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Your total compensation goes beyond the number in your paycheck. SBUH provides generous leave, health plans, and a state pension that add to your bottom line.