Job Details: Level: Management, Job Location: Hiveley Corp - Inkster, MI, Position Type: Full Time, Education Level: 4 Year Degree, Salary Range: Undisclosed, Job Category: Nonprofit - Social Services, POSITION SUMMARY: The Revenue Cycle Manager is an essential member of a high performing management team who oversees client account activities, clinician/provider privileging and credentialing functions. The manager ensures the organization is compliant with local, state, and federal standards, policies, and guidelines. Work collaboratively to create and maintain a culture of excellence and dedication to providing compassionate and high-quality care to the people we serve and the community. EDUCATION AND EXPERIENCE: •    Bachelor’s degree or higher in business, healthcare administration or another related field.  •    At least two (2) years’ previous experience in a supervisory or management capacity required. DUTIES & RESPONSIBILITIES: •    Oversee and optimize the end-to-end revenue cycle, including charge entry, coding, claims submission, payment posting, and collections. •    Develop, implement, and maintain revenue cycle policies and procedures •    Manage daily operations of the revenue cycle department to meet financial and operational goals •    Ensure accuracy and timeliness in account reconciliation, pre-collection, and post-collection processes •    Investigate and resolve billing and authorization issues across public and private payers.     •    Maintain oversight of Service Activity Log processes to ensure regulatory compliance as well as state and federal guidelines.  •    Lead denial management efforts, including identification, analysis, and resolution of claim denials and rejections •    Implement strategies to reduce A/R days, improve collections, and enhance profitability •    Analyze payer contracts and reimbursement trends to optimize revenue •    Recommend and implement process improvements to reduce errors and improve outcomes •    Basic denial trend analysis and reporting •    Ensure adherence to HIPAA, payer requirements, and federal/state regulations •    Maintain up-to-date knowledge of payment reform and industry changes •    Oversee internal and external audits, including quarterly coding audits, and implement corrective actions •    Ensure provider documentation is completed accurately and within required timelines •    Hands-on problem-solver in all aspects of collecting and billing including but not limited to working with funding partners. •    Performs personnel functions such as hiring, training, terminating, and conducting employee evaluations and disciplinary actions, as necessary.  •    Ensure accuracy and integrity of patient billing information and internal records •    Responsible for updating and correcting authorization errors that prevent services from being billed.   •    Monitors and maintains insurance contracts with all payers.  •    Ensures all providers are associated with each health plan contract and system is set up to accurately bill those health plans.  •    Stays abreast of payment reform changes and advises the administration team of these changes and provides recommendations for changes necessary.  •    Lead end-to-end provider credentialing and enrollment processes •    Ensure timely credentialing/privileging, re-credentialing, and payer enrollment of behavioral health employees and clinic locations.  •    Enroll, update and re-attest as necessary for all health plan enrollment activity, keeping a detailed listing of all providers and their status with each contracted health plan.  •    Establish and maintain compliant credentialing policies and workflows •    Serve as the primary contact for credentialing with health plans, auditors, and regulatory agencies •    Cooperates in any investigation related to personnel, licensing, accreditation, or other circumstances. •    Communicate in a professional manner with various Starfish Family Services team members, Detroit Wayne Integrated Health Network (DWIHN), health plans, and other    entities.  •    Evaluate and initiate process improvement with clinical leadership to ensure efficient/effective day to day operations for responsible areas and stay current on any upcoming payer changes.  •    Provides reports and details to management team to carry out the necessary steps for a claim to be billable.  •    Training and educating management team on billing practices and revenue cycle processes.    •    Serves as the primary contact and expert for insurance companies as well as building and executing reports that accurately depict important business metrics and departmental metrics. •    Actively seeks opportunities to improve financial outcomes, engaging revenue cycle team members in the process. •    Responsible for following up on DWIHN risk matrix data. Provide summary and reports to senior leadership team. •    Responsible for recommending changes to the senior director that would improve service delivery.  •    Support the CFO with financial reporting, audits, and cost reporting •    Enhance workflow and revenue outcomes by analyzing (clinical) operational implementations, events, and potentially extended service lines of care that may result in         heightened reimbursement.  •    Tracking and updating clinical reports and ensuring timely and routine updates are provided by clinical services team members.       •    Completion of reports from DWIHN to include but not limited disenrollment report and MCO report. •    Participates in continued professional development including research and program presentation activities. •    Attends local, county, state, and agency meetings and training courses as required. •    Performs other duties as assigned by senior management.   KNOWLEDGE, SKILLS, & ABILITIES: •    Knowledge of general accounting principles and medical terminology.  •    Knowledge and understanding of state and federal rules and regulations regarding confidentiality, compliance, release of information, Fair Debt Collection practices, and insurance regulations.  •    Knowledge of principles and techniques used in negotiation as applied to service contracts and equipment purchasing.  •    Effective organizational, planning and project management abilities.  •    Experience in financial and programmatic presentations.  •    Demonstrated creativity and flexibility.  •    Ability to operate in high-pressure situations.  •    Demonstrated innovative approach to problem resolution. •    Experience with credentialing/impaneling of providers/facility eligibility with payers highly preferred.  •    Knowledge of ICD-10 Codes, CPT Codes, HCPCS Codes, Revenue Codes, and Place of Service Codes.  •    Experience working in Behavioral Health EHR system(s).  •    Intermediate level experience working in Microsoft Suite applications.  •    Knowledge of community mental health treatment programs and their continuum of care. •    Knowledge of supervisory principles and practices including personnel and systems management. •    Ability to communicate effectively both orally and in writing. •    Ability to manage multiple priorities, functions independently, and demonstrate good follow through. •    Ability to work positively and productively as a member of a team of colleagues, supervisors, agency staff and collateral contacts. •    Ability and willingness to give and receive constructive feedback. •    Ability and desire for personal and professional growth and skill development. •    Must be culturally sensitive and competent in working in a multi-cultural environment.  •    Must demonstrate capacity for developing autonomy and leadership among employees.  •    Must demonstrate skills in working tactfully with others. •    Flexible in assumption of responsibilities. •    Must maintain ethical and professional standards. •    Ability and willingness to work with all members of the community regardless of race, age, gender and cultural or ethnic background. •    Ability to represent the agency in a professional manner. LICENSING AND OTHER REQUIREMENTS: •    Must have a valid State of Michigan driver’s license and automobile insurance. Starfish Family Services is an Equal Opportunity Employer  EOE/M/F/D/V :