Manager, Revenue Cycle Management

Emploi pas sur LinkedIn

🕒 il y a 7 jours

🇺🇸 États-Unis – Télétravail

⏰ Temps Plein

🟠 Senior

🔴 Expert

👔 Manager

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Theoria Medical

Site WebLinkedInTous les Emplois

1001 - 5000 employés

⚕️ Assurance santé

☁️ SaaS

📡 Télécommunications

Healthcare Insurance • SaaS • Telecommunications

Theoria Medical est un leader des soins primaires basés sur la valeur et enrichis par la technologie, révolutionnant les soins de santé pour les communautés de résidences pour seniors à l'échelle nationale. L'entreprise emploie un modèle de soins entièrement intégré, combinant des services de soins primaires avec les dernières avancées technologiques pour offrir une expérience de santé holistique et impactante pour les séniors. Ses offres innovantes incluent la télésurveillance des patients, la direction médicale, le personnel médical sur site, la télémédecine et les optimisations de flux de travail, le tout soutenu par des technologies pionnières telles que ChartEasy, ChatEasy et ProphEasy. Theoria Medical s'engage à améliorer les résultats des patients grâce à l'innovation numérique et sert des patients dans des environnements de soins de courte durée, de résidence assistée et de vie indépendante à travers les États-Unis.

Description

• Lead and manage the revenue cycle operations, including but not limited to billing, holds/credentialing, denials, collections, and accounts receivable management. • Assist in developing and implementing KPIs and policies and procedures to ensure accurate and timely submission of claims, reduce denials, and increase collections. • Analyze trends impacting charges, coding, collection, and accounts receivable and take appropriate action to realign staff, third party vendors and revise policies and procedures. • Identify and resolve revenue cycle issues, including coding and billing errors, incomplete or inaccurate patient information, insurance prioritization and other issues that may impact revenue. • Monitor and analyze revenue cycle metrics, including accounts receivable aging, claim submission, payment turnaround times, and denial rates. • Analyze billing and claims for accuracy and completeness; follow up with RCM teams and third party vendors on work queues, pending claims and unpaid AR. • Spearhead the resolution of rejected or underpaid claims by conducting targeted appeals and payer negotiations. • Analyze and manage overpayments from payers as well as implementing policies to reduce denials and refunds. • Work with credentialing, billing and coding staff to ensure compliance with regulatory requirements, including HIPAA and other federal and state regulations. • Develop and maintain strong relationships with RCM Directors, HR, Clinical Operations and Credentialing departments to ensure a smooth revenue cycle operation. • Review and respond to various payor correspondence • Communicate with patients and clients

🎯 Exigences

• 7+ years of experience in revenue cycle management in a healthcare setting • Advanced knowledge of the healthcare industry and a strong financial background • Clear understanding of billing and collection regulatory guidelines and requirements • Vast CPT and ICD-10 expertise • Vast knowledge in credentialing and payor management • Proficient background in reimbursements • Experience in monitoring clearinghouse activity, reports, and processes • Experience in setting up payors with EDI, ERA, and EFT processes • Experience in managing and leading a team of revenue cycle professionals • Strong analytical skills and attention to detail • Ability to work in a fast-paced environment and manage multiple projects simultaneously • Agility, strong leadership, problem-solving skills • Ability to maintain up-to-date knowledge of technology and software including but not limited to Monday, Slack, Google suite of Applications, spreadsheets (Excel), Zoom, MS Teams, eClinicalWorks

🏖️ Avantages

• Competitive Compensation • 401k with Employer Match • Health, Dental, and Vision Insurance • PTO and Holiday Pay • Employer Paid Life insurance Policy • Short and Long-Term Disability Insurance • Company Provided Equipment • Employee Assistance Program (EAP)