Revenue Cycle Manager

📋 Description

• Responsible for developing and sustaining the priorities, procedures, and policies of the revenue cycle department at Exact Sciences.

• Establish appropriate and effective performance metrics and staffing requirements to ensure the department operates efficiently and accurately while delivering exceptional customer service.

• Create processes and procedures that facilitate the smooth exchange of interdependent information among the third-party billing vendor, the receivables department, and the Exact Sciences contact center.

• Design and implement key strategies and infrastructures to enhance the collection of earned reimbursements for lab operations.

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

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

• Analyze denial sources and trends, resolving issues and pursuing appeals with cross-functional team collaboration.

• Ensure compliance with billing regulations from all third-party payers.

• Guarantee customer satisfaction through courteous and effective communication, problem-solving, and efficient processes across all personnel.

• Manage and oversee the daily operations of the revenue cycle department and all accounts receivable functions.

• Inspire the team to meet month-end goals and metrics.

• Provide month-end activity reports to key leadership.

• Foster and exemplify a collaborative team environment that encourages effective teamwork both within and outside the department.

• Monitor departmental processes to ensure compliance with performance metrics, communicating findings to leadership in a timely and effective manner.

• Hire, coach, inspire, and motivate the team; implement and track staff productivity and service performance metrics, reporting to leadership.

• Maintain confidentiality in accordance with HIPAA regulations and ensure that the department adheres to all relevant regulations.

• Implement and assist with innovative staff education programs.

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

• Utilize a deep understanding of payer/insurance appeals and reimbursement processes, with experience in the insurance industry and professional billing.

• Apply knowledge of Medicare billing regulations, compliance, and reimbursement methodologies, particularly in the laboratory setting.

• Leverage familiarity with third-party billing service providers (e.g., Xifin, Epic) or revenue cycle management software and outsourced billing organizations.

• Demonstrate strong analytical and forecasting skills with a proven ability to plan workloads, allocate tasks, and scale operations to align with business priorities.

• Oversee and implement staff reporting while establishing key productivity and accuracy metrics.

• Exhibit strong organizational and problem-solving skills.

• Maintain adaptability, openness to change, and ability to navigate ambiguous situations, responding effectively to new information and unexpected circumstances.

• Utilize strong interpersonal and teamwork abilities, effectively conveying concepts and priorities, as well as soliciting feedback and input.

• Demonstrate strong presentation skills, able to adjust communication styles based on the audience.

• Inspire and motivate others while effectively collaborating and influencing team dynamics.

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

• Maintain regular and reliable attendance.

• Ability to work a standard schedule of Monday through Friday during regular business hours.

• Capability to work in front of a computer screen and/or type for approximately 80% of a typical workday.

⛳️ Requirements

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

• Over 8 years of experience in the medical/healthcare billing sector, demonstrating strong knowledge in claims processing management.

• More than 5 years of leadership experience, showcasing the ability to recruit, assess, motivate, and inspire others to contribute to business success.

• Authorization to work in the United States without sponsorship.

• Proven ability to perform the essential duties of the position with or without accommodation.

🏝️ Benefits

• Paid time off, including vacation days, holidays, volunteering, and personal time.

• Paid leave for parents and caregivers.

• Retirement savings plan.

• Wellness support.

• Health benefits that include medical, prescription drug, dental, and vision coverage.