Revenue Cycle Manager

Vaga não está no LinkedIn

🕒 Outubro 27

🏄 California – Remoto

🏄 California – Remote

💵 $95.000 - $100.000 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

🦅 Patrocina Visto H1B

Esta empresa já patrocinou vistos H1B no passado.

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Florence Health

SiteLinkedInTodas as Vagas

51 - 200 funcionários

Fundada em 2018

🏥 Saúde

⚕️ Seguro de Saúde

Healthcare • Healthcare Insurance

A Florence Health é uma empresa de saúde com sede em Arlington, VA, dedicada a criar um sistema de cuidados primários melhorado, focado principalmente em idosos nos Estados Unidos. Inspirando-se em Florence Nightingale, a empresa busca aprimorar a prestação de serviços de saúde através de práticas independentes e clínicas especialmente desenhadas para melhorar o acesso, o engajamento médico e a experiência do paciente. A Florence Health apoia uma rede de provedores de cuidados primários de alto nível, que se beneficiam da afiliação enquanto mantêm sua independência. Sua iniciativa é fortalecida pelo Nightingale Technology, uma plataforma projetada para fornecer "super dados de saúde" para melhorar a eficiência clínica e operacional.

Descrição

• Own billing, provider enrollment, and billing compliance for Integrated Complex Care Associates • Enroll and onboard physicians, including 855I reassignments, 855B practice locations, PECOS and NPPES updates, revalidations, and Medicare EFT/remittance setup • Configure physician offices to submit ICC patient claims through ICC's payer ID and confirm end-to-end claims flow • Maintain the provider roster, including physician payment arrangements • Serve as the main billing contact for physician offices and conduct onboarding sessions • Review every claim before submission to Medicare, checking CPT/HCPCS codes, modifiers, place of service, units, and diagnosis codes • Approve, correct, or return claims to physician offices; release approved claims to Medicare under ICC's TIN • Track claims through payment or denial • Sample claims against physician EMRs, monitor physician error rates, and issue compliant documentation queries when appropriate • Provide coding feedback and escalate patterns to physician leadership • Post and reconcile Medicare remittances, work rejections and denials, and file corrections, reopenings, and appeals • Reconcile Medicare payments to ICC with payments made to physicians or physician practices • Explain ICC billing to patients and answer billing questions • Screen rendering physicians and billing staff monthly against OIG and SAM exclusion lists • Maintain billing and coding policies, document audits, and report findings to physician leadership • Identify, report, and return Medicare overpayments within the federal 60-day rule • Use physician EMR access only for ICC patients and as necessary under HIPAA • Work under ICC physician leadership while employed and administratively supported by Integrated Complex Care MSO LLC

🎯 Requisitos

• 5+ years of Medicare Part B professional billing for physician groups, including claim review, denials, and appeals • Hands-on Medicare provider enrollment, including PECOS, 855I reassignments, 855B group enrollment, and revalidations • Current coding credential: CPC or CPB (AAPC) or CCS-P (AHIMA) • Working knowledge of ICD-10-CM, CPT/HCPCS, modifiers, and HCC risk-adjustment documentation standards • Claims management experience through a clearinghouse or billing portal, including 837P, 277CA, and 835 • Billing compliance experience with audits, exclusion screening, overpayment refunds, and HIPAA • Familiarity with Medicare ACO programs such as MSSP, ACO REACH, or LEAD is a plus • Clear, patient phone and writing skills with physicians, office staff, and older patients • Spanish is a plus • Comfort building processes from scratch and working independently • Must live in California • Ability to work Pacific time business hours

🏖️ Benefícios

• Remote work within California • Pacific time business hours • Occasional travel to physician offices around California • Background check after a conditional offer • OIG and SAM exclusion check • HIPAA training before system access

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