REVENUE CYCLE HC MGR 1

Responsible for achieving broadly stated goals through subordinate team members

as defined below.

Ensures the implementation of all revenue cycle policies and establishes, updates, and revises procedures as needed. Researches and incorporates best practices to maintain alignment with current industry standards, regulatory requirements, and emerging trends.

The Revenue Cycle Manager serves as the principal administrative representative of the CPG Business Office to Zuckerberg San Francisco General Hospital, campus administration, and demonstrates leadership in various committees, and task force services. The incumbent ensures communication development and implementation of mutual goals and objectives, and problem resolution.

The Manager is required to maintain a strong and functional knowledge of physician billing and reimbursement as well as pertinent local, state, and national issues related to the healthcare industry in the area of academic medicine. Develop, implement, and monitor quality control standards to ensure proper billing, coding and compliance including Medicare and Medi Cal compliance. This involves working with Client Managers to develop a working plan to meet the billing requirements and back Managers within the department to implement processes.

Proactively, research and address issues/problems constructively, follow through to ensure timely resolutions that in turn improve efficiency, compliance and maximize revenue. Compliance must be maintained to fulfill UCSF requirements and also in accordance with the Department of Public Health under our Affiliation Agreement with SFGH. Contingencies such as UC's annual cash security review must be fulfilled just the same with SFGH's Service Excellence training to maintain our competitiveness as a healthcare facility. It is the Revenue Cycle Manager's role to ensure that all staff meet these requirements to support the revenue cycle.

Manage billing and collection operations related to the revenue cycle, including hiring orientation, training required by both UC and San Francisco

General Hospital, development, coaching, corrective actions, and ongoing monitoring of all staff work-related activities.

Maintain and enhance billing policies and procedures for each function in the Revenue Cycle process to ensure staff adherence to policies.

Ensure consistent quality of the billing service by work redistribution based on skill level and competency to meet the department's productivity

standards.

(Does not include oversight of business office functions.)

Applies proven human resource management skills in staff selection, development, and evaluation. Fosters a strong culture of teamwork and quality customer service to all constituencies to ensure the quality of daily revenue cycle operations, effective interdepartmental collaborations, and the timely achievement of objectives.

Responsible for achieving broadly stated goals through subordinate team members as defined below

Provide mentoring, coaching and performance reviews for both direct reports and indirect reports. Enforce bi-annual performance reviews adopted are perform

Assure that staff meets requirements imposed by UCSF standards and the Department of Public Health (TB/Flu testing, Compliance, Sexual Harassment etc. training,

Works directly with the Director to coordinate training resources and ensure staff are prepared and equipped to adapt to evolving healthcare regulations, industry updates, and operational changes.

Promote employee safety and provide ergonomic resources for staff personnel

Maintain annually department's Emergency Action Plan and Mission Continuity Plan in compliance with UCSF's operational standards.

Establishes processes, metrics and monitoring systems to maximize reimbursement and cash collections. Provides recommendations and corrective action as appropriate.

Delegates projects, directs and monitors work efforts, identifies resource needs, performs quality reviews, and proactively addresses or escalates functional, quality, and timeline related issues to ensure successful project completion and operational effectiveness.

Manages and drives continuous improvement initiatives across all areas of the revenue cycle, identifying opportunities to enhance operational efficiency, optimize financial performance, strengthen compliance, and improve service delivery.

Ensure consistent quality of the billing service by work redistribution based on skill level and competency to meet the department's productivity

standards.

Monitors CPG and Department Workqueues to ensure timely processing of accounts.

Collaborates with leadership from business units across the medical center (decision support, reimbursement, billing, medical records, clinical units, etc.), to propose new or revised standardization of criteria and measurements, improve workflows, coordinate activities, and resolve issues. Partners with information technology on enhancements and new systems for efficient billing, AR and patient accounting processes.

The Revenue Cycle Manager will maintain regular and effective communication with all existing and prospective clients of the CPG Business Office. Working with the Chiefs of Service and Department Managers regarding effective and efficient service operation as well as adherence to all regulatory requirements associated with the reimbursement processes.

Works directly with the Director to coordinate training resources and ensure Departments are prepared to adapt to evolving healthcare regulations and industry updates.

Conducts assessments and coordinates the development of training program (job tools, aides and learning delivery methods). Ensures subordinate staff provides departments with ongoing education and training on revenue cycle management policies and procedures.

Provides training resources and development opportunities to support staff in performing their job duties effectively and advancing their careers. Utilizes feedback from sources such as Gallup Employee Engagement Surveys, staff input, performance evaluations, and operational assessments to identify training needs and foster professional growth.

Supports client departments by allocating appropriate resources and providing guidance to help them maximize the use of available reporting tools for financial analysis, operational decision-making, and performance monitoring.

Serves as the liaison between the IT design / build / testing team, the deployment team, as well as revenue cycle and financial business owners.

Collaborate with CPG IT during changes occurring to the EPIC Billing System.

Participate actively in revenue cycle workflows impacting daily operations.

Request system updates as applicable, for charging edits, claim edits and submissions, and denial trends,

Responsible for achieving broadly stated goals through subordinate team members

as defined below.

Ensures timely billing and follow up on patient accounts, implementing sound processes, metrics and monitoring systems

Oversees billing management staff to ensure the accurate and timely submission of claims and collection of payments in accordance with all third party payer contracts, including Medicare, Medi Cal, Managed Care, Commercial Insurance, and patient responsible balances.

Oversee the review, resolution, and resubmission of unprocessed, aged, and denied claims to maximize reimbursement and optimize revenue cycle performance utilizing the Epic billing system