Nationwide Children's Hospital

Physician Revenue Cycle Manager

Posted Date 1 month ago(8/14/2020 12:17 PM)
Requisition ID


Physician Revenue Cycle Manager


We are seeking a Physician Revenue Cycle Manager

The Physician Revenue Cycle Manager is a key member of the management team responsible for providing day-to-day guidance and direction to the team under the oversight of the Director, Patient Accounts Professional Billing.  As Manager, you will provide knowledge and analysis of payer rules and regulations for professional billing, while providing direct oversight to a team of physician revenue cycle representatives (AR/Coding/Charge Entry/Cash Posting/Customer Service). You will be vital in making informed decisions to enhance procedures and implement changes as needed to ensure optimal reimbursement with regulatory requirements. You will play a key role in assisting the unit with providing information to Revenue Cycle leadership regarding issues related to payer policies, billing, posting, claims payment and reimbursement. The Manager will work collaboratively with peers and subordinates to assure the smooth operation of the Revenue Cycle department while maximizing cash flow and return on behalf of our CCP providers, in keeping with the missions of Nationwide Children’s Hospital.



Professional Billing Department

3592 Corporate Dr Ste 105

Columbus, Ohio 43231


SCHEDULE:  (Full-Time; Salaried position)  Monday - Friday, day shift


Why Nationwide Children’s?

The moment you walk through our doors, you can feel it. When you meet one of our patient families, you believe it. And when you talk with anyone who works here, you want to be part of it, too. Welcome to Nationwide Children’s Hospital, where Passion Meets Purpose.

Here, Everyone Matters. We’re 12,000 strong. And it takes every single one of us to improve the lives of the kids we care for, and the kids from around the world we’ll never even meet. Kids who are living healthier, fuller lives because of the knowledge we share. We know it takes a Collaborative Culture to deliver on our promise to provide the very best, innovative care and to foster new discoveries, made possible by the most groundbreaking research. Anywhere.

Ask anyone with a Nationwide Children’s badge what they do for a living. They’ll tell you it’s More Than a Job. It’s a calling. It’s a chance to use and grow your talent to make an impact that truly matters. Because here, we exist simply to help children everywhere.

Nationwide Children’s Hospital. A Place to Be Proud.


What Will You Be Doing?

  • (AR) Comprehensive understanding of CPT, ICD-10, and HCPCS coding; Knowledge of payer submission requirements; excellent oral and written communication skills. Knowledge of cross-departmental hospital and physician billing policies, third party payer processes and regulatory and accreditation requirements including 837P and 1500 claim form to ensure timely and accurate charge capture, billing and maximized reimbursements.
  • (Billing) Responsible for leading and managing all revenue cycle activities related to professional charge capture, edit review (clearinghouse, claim, payer) to ensure timely and accurate charge capture, billing and maximized reimbursements.
  • The Manager meets regularly with department Supervisors to review processes, work flows, and overall team performance.
  • Leads the department through process improvement opportunities, standardization of work flow (best practices) and performance management through strategic evaluation.
  • The Physician Revenue Cycle Manager coaches, counsels, and mentors the team to develop staff and improve teamwork, morale and overall performance and results.
  • Develops key performance indicators (KPIs)/dashboard to identify trends, track results and identify opportunities for process improvement, enhanced performance, and maximized reimbursement.
  • Develops department goals to support the business objectives.
  • Develops productivity and collections targets, communicates expectations to staff and follows-up with Department Supervisors, as needed, based on results.
  • Demonstrates excellent initiative and judgement. Works independently applying effective approaches to task prioritization, time management, delegation of tasks and meeting deadlines.
  • Exhibits outstanding decision making and customer service.
  • Cultivates and maintains positive and productive business relationships with departmental leadership, staff, vendors, and payer representatives.
  • Works collaboratively to improve processes, communicate barriers within revenue cycle and works towards resolution.
  • Promotes a work environment of accountability and ownership.
  • Sets appropriate standards of performance and communicates clear expectations to the Supervisors.
  • Shows direct and tangible evidence of coaching, mentoring, and professional development.
  • Conducts standing one-on-one meetings with direct reports to provide a structured time to provide coaching, discuss accomplishments, and review the status of revenue cycle operations within their scope of responsibility. Discuss areas of professional development as well as goal tracking/reporting, projects, and other pertinent topics. Maintains comprehensive and concise documentation of the one-on-one sessions, next steps, and expectations.
  • Performs other duties as assigned.


What Are We Looking For?        

To fulfill this role successfully, you must possess these minimum qualifications and experience:

  • Bachelor degree in Business Administration or related field, or equivalent combination of education and experience. 
  • CPC or CCS-P coding certification required.  
  • Minimum of three-five years of management experience in healthcare industry with previous professional billing experience preferred.
  • Knowledge required of medical terminology, CPT and ICD-10 coding, HIPAA transaction standards, various claim forms, third party contracts and payment patterns, reimbursement regulations and policies of third party payers.
  • Detailed understanding of a managed care environment and its impact on the bottom line.
  • Demonstrated ability to effectively manage multi-disciplined projects and multiple people.
  • Excellent communication, financial analysis, problem solving, and customer service skills.
  • Working knowledge of computerized physician billing systems, extensive experience using Excel, Outlook, and Word.
  • Demonstrated traits of teamwork, cooperation, and positive and enthusiastic role model.
  • Strong professional demeanor with the inherent quality to rapidly establish credibility and rapport with clinicians, managers and external groups.
  • Demonstrated ability to identify opportunities for process improvement, identify solutions and plan for and implement those same solutions.

Your Benefits, Your Wellness:

As an employer, Nationwide Children’s recognizes the importance of the benefits we offer. We also recognize the importance of balancing your work and personal needs.  Our benefits and Employee Wellness package is designed to:

  • Empower you to be a conscientious health care consumer through educational and wellness activities
  • Establish a work environment that promotes health and well-being
  • Support your financial protection and security in retirement
  • Most of our positions are benefits’ eligible from day 1.

Minimum Physical Requirements:

  • Sitting - frequently
  • Talking on phone/in person - frequently
  • Typing on a keyboard – frequently
  • Physically Active - frequently

EOE M/F/Disability/Vet


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