Revenue Cycle Manager

Job not on LinkedIn

🕒 3 days ago

🏄 California – Remote

🏄 California – Remote

💵 $95k - $100k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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This company has sponsored H1B visas in the past.

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Florence Health

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2018

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Florence Health is a healthcare company headquartered in Arlington, VA, dedicated to creating an improved primary care system focused primarily on seniors in the United States. By taking inspiration from Florence Nightingale, they aim to enhance healthcare delivery through a mix of independent practices and clinics specifically designed to improve access, medical engagement, and patient experience. Florence Health supports a network of top-tier primary care providers who benefit from affiliation while maintaining their independence. Their initiative is further strengthened by Nightingale Technology, a platform designed to deliver "health care super data" to improve clinical and operational efficiency.

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

• 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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