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Financial Specialist IV - Revenue Cycle Manager

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Financial Specialist IV - Revenue Cycle Manager

Salary

$85,318.48 - $142,197.95 Annually

Location

FAIRFAX (EJ32), VA

Job Type

FT Salary W BN

Job Number

25-01106

Department

Community Services Board

Opening Date

05/31/2025

Closing Date

6/20/2025 11:59 PM Eastern

Pay Grade

S29

Posting Type

Open to General Public

+ Description

+ Benefits

+ Questions

Job Announcement

Under the general direction of the senior fiscal officer, serves as the revenue cycle manager for the Fairfax Falls-Church Community Services Board (CSB) supervising a professional level staff for billing, insurance, and customer service functions. Performs various financial functions, including financial data analysis, preparation of revenue projection, forecasts, and reconciliation. Manages all aspects of the revenue cycle to include billing and collection activities from both public and private payers. Ensures the department is following the applicable state, federal, and county requirements, financial policies, regulations, and procedures. Participates in meetings/work groups as a member of CSB management team. Management responsibilities include policy planning, strategic planning, communication of policy changes or updates, project coordination, directing, organizing, and personnel management. Produces financial reports, analyzing trends, and delivers monthly updates to the executive and clinical and operational leadership on billing and collection activities from multiple payers. Provides leadership, coordination, and subject matter expertise across all components of the CSB's programs and services related to the revenue cycle practices and procedures to include Sate Performance Reporting activities.

Duties and Responsibilities include:

+ Participates in administration and support activities as a core member of the fiscal team.

+ Manages the day-to-day billing operations and the self-pay collection related activities to ensure that the information provided for billing is accurate and timely.

+ Identifies areas to improve the revenue cycle, such as data integrity, evaluation of clients facing claim or collection issues to enhance medical billing functions.

+ Develops and communicates billing policies and procedures to ensure timely filing of medical claims and to meet clean claim targets.

+ Provides oversight for insurance payment receipt process to include banking and cash postings as well as reconciliation into the financial system.

+ Leads insurance denial processes and oversees the appeal process as appropriate to avoid delays in revenue collections and to maximize revenue generation.

+ Oversees the entire pipeline of charge to capture activities; reviews to correct coding data and provides oversight to ensure accurate reimbursement for services billed. Requires experience working within an environment with an electronic health record system.

+ Directs accounts receivable process, monitors adjustments and assesses write-off processes to generate periodic reports for senior leadership.

+ Identifies and resolves operational and system issues and collaborates with relevant parties to troubleshoot effectively.

+ Maintains revenue management dashboard with defined key performance index metrics. Keeps abreast of current knowledge of changes in compliance standards, payer policies and state/federal regulations concerning coding, billing, and reimbursement processes.

+ Coordinates responses to inquiries from internal auditors or partner agencies regarding billing and collection practices as well as revenue reconciliation.

+ Prepares third party revenue projections and consistently works to enhance successful revenue generation from CSB services delivered.

+ Supervises professional level staff for a variety of functions related to revenue cycle in relation to fiscal management.

+ Monitors, tracks, and evaluates staff productivity and performance. Ensures that team members are adequately trained and in compliance with the billing practices and procedures of the county as well as state agencies.

+ Provides communication and maintains relationships with stakeholders, including third party payers.

+ Attends with relevant staff members to represent the CSB at statewide professional conferences and meetings with other jurisdictions and local cities.

+ Develops and implements metrics as well as measurement tools to perform compliance monitoring functions.

+ Ensures timely and accurate issuance of client statements.

+ Delivers financial reports and regularly conducts complex financial analysis regarding trends to determine fiscal impact, produces charts/tables/graphs to depict the results for delivery to various county stakeholders.

+ Assists with fee schedule process, provides revenue data to include accounts receivable info for the submission of the State Performance Contract Report annually and at mid-year.

Note: To learn more about careers that make a difference, watch our video "CSB Celebrates 50th Anniversary of Providing Care."

Illustrative Duties

(The illustrative duties listed in this specification are representative of the class but are not an all-inclusive list. A complete list of position duties and unique physical requirements can be found in the position job description.)

+ Oversees a group of financial staff performing complex work;

+ Assists the Fiscal Manager with development and annual compilation of the annual, quarterly, and carryover budgets;

+ Assists in the development and implementation of fiscal management and accounting procedures for the agency;

+ Maintains financial policies and procedures and has direct oversight of audits;

+ Coordinates and oversees audit processes;

+ Ensures compliance with all applicable Federal, State and County regulations and procedures.

Required Knowledge Skills and Abilities

(The knowledge, skills and abilities listed in this specification are representative of the class but are not an all-inclusive list.)

+ Extensive knowledge of the principles, methods, and practices of governmental budgeting and financial management;

+ Thorough knowledge of intergovernmental financial management, grant management and contract management;

+ Ability to plan and implement activities to ensure effective and efficient utilization of resources.

Employment Standards

MINIMUM QUALIFICATIONS:

Any combination of education, experience, and training equivalent to the following: (https://www.fairfaxcounty.gov/hr/equivalencies-education-and-experience) (Click on the aforementioned link to learn how Fairfax County interprets equivalencies for "Any combination, experience, and training equivalent to")

Graduation from an accredited four-year college or university with either a bachelor's degree in accounting, business administration, public administration, public policy or related field; plus, four years of professional-level experience in finance, business administration, budgeting, or contract management, a master’s degree in a related field or CPA may substitute for 1 year of experience.

CERTIFICATES AND LICENSES REQUIRED:

Valid Driver's License

NECESSARY SPECIAL REQUIREMENTS:

The appointee to this position will be required to complete a criminal background check, a Child Protective Services Registry check, a driving record check, and sanction screening to the satisfaction of the employer. A TB screening upon hire.

Certain positions with financial responsibility within this class may be subject to criminal history record checks and/or credit checks as a condition of employment and periodically thereafter, as determined by the department head. An applicant or an employee may be required to submit a request for a criminal history record check and/or credit check to the appropriate agency; Applicants and employees within these positions must demonstrate financial responsibility in personal finances as a condition of employment.

This position is emergency/essential services personnel. (Required to report for duty during inclement weather and/or other emergencies.)

PREFERRED QUALIFICATIONS:

+ Certified Professional Coder (CPC) certification

+ Master's degree in finance, business administration, accounting, public administration, public policy, healthcare administration, or related field.

+ Five or more years serving as revenue cycle manager for a behavioral health agency.

+ Five or more years working in a managed care environment in the Commonwealth of Virginia

PHYSICAL REQUIREMENTS:

The work is generally sedentary and is usually performed in an office environment. Ability to make presentations and communicate clearly and concisely, both orally and in writing. Ability to attend evening meetings off-site. All duties performed with or without reasonable accommodations.

SELECTION PROCEDURE:

Panel Interview and may include a practical exercise.

Fairfax County Government prohibits discrimination on the basis of race, color, religion, national origin, sex, pregnancy, childbirth or related medical conditions, age, marital status, disability, sexual orientation, gender identity, genetics, political affiliation, or military status in the recruitment, selection, and hiring of its workforce.

Reasonable accommodations are available to persons with disabilities during application and/or interview processes per the Americans with Disabilities Act. TTY 703-222-7314. [email protected] EEO/AA/TTY.

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