Job Description

ESSENTIAL FUNCTIONS

The REVENUE CYCLE MANAGER (Collection Specialist Manager) will oversee a team of reimbursement/billing specialists and is responsible for understanding all aspects of the billing process. This position will ensure claims are being processed in a timely manner and follow-up is completed on claim denials

LEADS EMPLOYEES IN ALL ASPECTS OF THE REVENUE CYCLE.

• Ensures staff is properly directed to achieve the greatest reimbursement legally possible for the practice.
• Establish and regularly measure through reporting on key performance indicators for the department including but not limited to accounts receivable, cash collections. Denials as a percent of net revenue, percentage of clean claims, controllable write-offs, etc.
• Accountable to ensure that the department is up to date with current rules and regulations of the insurance payors.
• Accountable for all aspects of the department including but not limited to: interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and coaching employees; addressing complaints and resolving problems.
• Possess complete understanding of the billing/collection process to resolve complex, outstanding claims.
• Ensures accounts are billed accurately and timely by providing proactive oversight and direction for billing and collections.
• Maintains current knowledge of healthcare billing systems and government payer systems, including applicable federal/state laws and regulations, as well as all aspects of third-party reimbursement policies and practices
• Demonstrates ability to supervise, train and motivate employees, as well as a professional attitude in relating to executive management, professionals, and third-party insurance carriers.
• Organizes and leads efforts to maximize operational efficiency and optimize reimbursement, as well as monitors denials and provides education and reporting to the areas regarding the effect of denials from their areas.
• Reviews payer contracts and credentialing
• Reviews all statistical reports to monitor trends, determine operational deficiencies and implement corrective action plans as necessary
• Manages and assures timely submittal of claims through effective supervision of staff
• All other duties as assigned.

Qualifications

EXPERIENCE REQUIREMENTS

• HS Diploma required. Secondary education preferred.
• 2-3 yrs. of Medical Billing Management or equivalent experience required.
• Min 5 yrs. Home Health care billing experience – Part B preferred
• Knowledge and understanding of billing regulations.
• Familiar with Billing Software, payer contracts and credentialing
• Proficiency with Microsoft Office and Strong Organizational and Time Management

Additional Information

EQUAL OPPORTUNITY EMPLOYER – vets, disability.

*** Must be fully vaccinated or be willing to complete full vaccination by date of hire and proof of vaccination will be required. If permitted by state law, the company will consider requests for religious or medical exemptions. ***