Supervisor, Rev Cycle Systems

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

📋 Description

• Oversee the daily operations of the Exact Sciences Laboratories Systems team.

• Provide leadership through supervision, recruitment, training, and coaching, while managing workloads and addressing escalated issues related to revenue cycle systems and analytics.

• Ensure precise data reporting and take responsibility for metrics, productivity measures, and other essential performance indicators.

• Facilitate the implementation of contracts and revenue pull-through activities, both proactively and reactively, with internal and external stakeholders as required.

• Ensure that billing and payment processes are efficient, timely, and compliant with corporate objectives, contracts, and regulations.

• Coach, mentor, and motivate team members to enhance overall performance.

• Assist in identifying and reporting system errors and developing workflow solutions.

• Oversee the creation and upkeep of payor and client master files to ensure timely and accurate updates or changes.

• Investigate and resolve electronic remittance discrepancies.

• Drive operational excellence in order entry and exception handling processes, focusing on process flow, data integrity, information alignment, and continuous improvement.

• Support and lead cross-functional initiatives across various departments.

• Serve as a liaison between different functional areas within Exact Sciences Laboratories.

• Collaborate with team leadership to support daily team operations.

• Lead the development and maintenance of a contract database and management system, working alongside credentialing and legal teams.

• Partner with finance and analytics to identify, analyze, and determine actions to address negative revenue pull-through scenarios across various payer segments, including Medicare Advantage, Blues, Medicaid, etc.

• Collaborate with RCT Managers to build and leverage relationships with billing operations staff and payers to resolve claim adjudication issues, both contractual and non-contractual.

• Assist in executing pull-through plans to achieve quarterly revenue targets.

• Initiate discussions with relevant Exact personnel early in the contracting process to provide an overview of the account and prevent delays in implementation.

• Report and propose system changes to Revenue Cycle Leadership and staff as necessary.

• Work in close collaboration with vendor and payor partners to identify and resolve systematic challenges.

• Provide systematic support to ensure the timely electronic submission of claims, including subscriber ID format, Z-code requirements, etc., in accordance with payor and contractual demands.

• Collaborate directly with Client Support and Implementation Services (CSIS) teams to ensure accurate and timely client implementations related to the revenue cycle.

• Develop and supervise processes and procedures to ensure the efficient flow of information between the third-party billing vendor, the receivables department, and Exact Sciences’ contact center.

• Assist in overseeing maintenance and updates concerning software vendor changes.

• Provide escalation support to staff.

• Participate in creating training and Standard Operating Procedures (SOP) materials as required and identify additional training needs/resources as necessary.

• Offer guidance on departmental priorities and ensure that tasks are completed accurately and punctually.

• Assist with recruiting, hiring, onboarding, coaching, and counseling department staff.

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

• Clearly communicate goals to employees to ensure understanding and success in achieving them.

• Ensure that suitable training opportunities are identified and provided to employees to enhance personal, career, and organizational development skills.

• Foster a team-oriented atmosphere that encourages effective collaboration both within and outside of the department.

• Provide ongoing coaching to staff to maintain a consistent level of service.

⛳️ Requirements

• Bachelor’s degree in Information Systems, Finance, Business, or a related field; or High School Degree/General Education Diploma with 4 years of relevant experience in lieu of a Bachelor’s degree.

• 3+ years of experience in the medical revenue cycle function, including third-party payer experience.

• 3+ years of experience in the medical/healthcare billing sector, with strong, demonstrated knowledge of Epic Resolute systems.

• 3+ years of experience working with a third-party billing service provider or revenue cycle management software.

• 2+ years of experience in a role with responsibilities for leading direct reports, including leadership positions.

• 5+ years of experience in a customer service environment focused on delivering an exceptional customer experience.

• Proven knowledge of medical coding, including International Classification of Diseases (ICD-9) and (ICD-10), as well as Coding Procedure Terminology (CPT) and HCPCS coding.

• Demonstrated understanding of Explanation of Benefits (EOB); must be able to read and interpret EOBs for all payers.

• Demonstrated understanding of ASC X12 (ANSI) claims adjustment and remark codes.

• Familiarity with Medicare billing regulations and reimbursement methodologies.

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

• Proven understanding of content development, facilitation, and evaluation of training.

• Demonstrated experience in customer service, billing, data entry, or a healthcare-related field.

• Proven ability to plan workload, allocate tasks, and scale operations to align with business priorities.

• Strong computer skills, including internet navigation, usage of virtual meeting/facilitation platforms, messaging services, and Microsoft Office programs.

• 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, including medical, prescription drug, dental, and vision coverage.