Manager, Revenue Cycle Management

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee and direct the operations of the revenue cycle, encompassing billing, credentialing, denials, collections, and management of accounts receivable.

• Aid in the formulation and execution of KPIs as well as policies and procedures to guarantee the precise and prompt submission of claims, minimize denials, and enhance collections.

• Examine trends affecting charges, coding, collections, and accounts receivable, taking necessary measures to realign personnel, third-party vendors, and amend policies and procedures accordingly.

• Detect and address revenue cycle challenges, such as coding and billing inaccuracies, incomplete or incorrect patient data, insurance prioritization, and other factors that could influence revenue.

• Track and assess revenue cycle metrics, including accounts receivable aging, claim submissions, payment turnaround durations, and denial rates.

• Review billing and claims for precision and thoroughness; engage with RCM teams and third-party vendors regarding work queues, pending claims, and outstanding accounts receivable.

• Lead efforts to resolve rejected or underpaid claims through targeted appeals and negotiations with payers.

• Evaluate and manage overpayments from payers while instituting policies aimed at reducing denials and refunds.

• Collaborate with credentialing, billing, and coding teams to ensure adherence to regulatory standards, including HIPAA and other federal and state regulations.

• Cultivate and sustain strong relationships with RCM Directors, HR, Clinical Operations, and Credentialing departments to facilitate a seamless revenue cycle operation.

• Review and respond to diverse payer correspondence.

• Engage in communication with patients and clients.

⛳️ Requirements

• A minimum of 7 years of experience in revenue cycle management within a healthcare environment.

• In-depth knowledge of the healthcare sector coupled with a robust financial background.

• Comprehensive understanding of billing and collection regulatory standards and requirements.

• Extensive expertise in CPT and ICD-10 coding.

• Significant knowledge in credentialing and payer management.

• Strong experience in reimbursements.

• Familiarity with monitoring clearinghouse activities, reports, and processes.

• Experience in establishing payers with EDI, ERA, and EFT processes.

• Proven track record in managing and leading a team of revenue cycle professionals.

• Excellent analytical abilities and meticulous attention to detail.

• Capacity to thrive in a dynamic environment while handling multiple projects at once.

• Strong leadership, agility, and problem-solving skills.

• Ability to keep current with technological advancements and software, including but not limited to Monday, Slack, Google Suite applications, spreadsheets (Excel), Zoom, MS Teams, and eClinicalWorks.

🏝️ Benefits

• Competitive Compensation.

• 401k with Employer Match.

• Health, Dental, and Vision Insurance.

• PTO and Holiday Pay.

• Employer Paid Life Insurance Policy.

• Short and Long-Term Disability Insurance.

• Company Provided Equipment.

• Employee Assistance Program (EAP).