Revenue Cycle Manager

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

📋 Description

• Lead the team and develop strategies for the entire revenue cycle process within a clinical independent laboratory.

• Communicate the health of the department to leadership through meetings, conference calls, presentations, and reports.

• Oversee billing compliance with regulations set by third-party payers.

• Implement and support staff education initiatives.

• Develop and sustain revenue cycle priorities, procedures, and policies for Exact Sciences.

• Determine performance metrics and staffing needs to ensure efficient and accurate department operations and customer service.

• Create processes for the flow of information between third-party billing vendors, receivables, and the Exact Sciences contact center.

• Design and implement strategies and infrastructure to enhance the collection of earned reimbursements for laboratory operations.

• Establish processes and policies for handling exceptions, appeals, denials, and balance billing.

• Monitor client accounts receivable activities and performance, initiating corrective actions as necessary.

• Investigate sources and trends of denials, resolving and appealing them in collaboration with cross-functional teams.

• Ensure customer satisfaction through courteous communication, effective problem-solving, and efficient processes.

• Supervise the daily performance of the revenue cycle department and accounts receivable operations.

• Inspire the team towards achieving month-end goals and metrics, reporting month-end activities to leadership.

• Encourage collaboration both within the department and externally.

• Monitor departmental processes against performance metrics and provide reports to leadership.

• Hire, coach, inspire, and motivate team members; manage productivity and service performance metrics.

• Maintain confidentiality and uphold HIPAA compliance.

• Supervise staff, organizing work, conducting performance reviews, training, and managing performance.

• Implement reporting for staff and key productivity and accuracy metrics.

• Support and adhere to the company’s Quality Management System policies and procedures.

• Maintain regular and consistent attendance.

⛳️ Requirements

• Authorization to work in the United States without the need for sponsorship.

• Bachelor’s degree in healthcare administration, business, or a related field; or a high school diploma/general education diploma with 4 years of relevant experience in place of a degree.

• Over 8 years of experience in the medical/healthcare billing sector.

• Proven and strong knowledge of managing claims processing.

• More than 5 years of leadership experience with a demonstrated ability to recruit, evaluate, motivate, and inspire others.

• Proven capability to perform essential duties with or without accommodation.

• Extensive knowledge and experience in medical billing, Medicare compliance, payer audits, the independent laboratory industry, and personnel management.

• Experience in personnel management, team leadership, and team development.

• Familiarity with payer/insurance appeals and reimbursement processes, as well as the insurance industry and professional billing.

• Understanding of Medicare billing regulations, compliance, and reimbursement methodologies, particularly in laboratory settings.

• Knowledge of third-party billing service providers such as Xifin and Epic, along with revenue cycle management software and outsourced billing organizations.

• Strong analytical and forecasting abilities.

• Excellent organizational and problem-solving skills.

• Adaptability and the ability to function in ambiguous situations.

• Strong interpersonal, teamwork, and presentation skills.

• Availability to work Monday through Friday during standard business hours.

• Ability to work at a computer and/or type for about 80% of a typical workday.

• Preferred qualifications: leadership experience in accounts receivable or billing operations; laboratory payer and provider billing experience; certifications such as CPC, CPM, CPCO, CPMA, or similar; membership in patient accounting organizations like AHAM.

🏝️ Benefits

• Equal Opportunity Employer for Minorities/Women/Individuals with Disabilities/Protected Veterans.

• Standard Monday through Friday schedule during normal business hours.

• Opportunity for remote work arrangements.

• Travel required approximately 10% of the time.