Revenue Cycle Manager

🔥 1 minute ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 12%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Icon Health is a value-based musculoskeletal (MSK) and orthopedic care company that partners with health plans, value-based care organizations, providers, and patients to deliver full-risk, end-to-end orthopedic services. It combines virtual and in-person access to orthopedic clinicians, a national network of aligned providers and facilities, and AI-powered predictive outreach and data-driven provider-efficiency scoring to lower orthopedic spend, improve outcomes (including HEDIS performance), and accelerate patient recovery.

📋 Description

• Manage billing and collections to ensure accurate claim submissions within 5 days of the patient date of service • Maintain an initial claim denial rate below 5% and a clean claim rate of 95% • Manage payment posting and reconcile EOB payments daily to bank deposits • Keep unapplied payments below 5% of total payments received • Manage outstanding accounts receivable, minimize balances aged over 90 days, and maintain average A/R days below 40 • Manage in-house and outsourced billing, collections, and coding staff • Track, analyze, and appeal payer claim denials • Monitor payer contract performance and fee schedules for underpayments and accurate reimbursement • Calculate and collect upfront patient financial responsibility using real-time eligibility tools • Audit high-reimbursement cases and reconcile underpayments against payer contract fee schedules • Ensure reimbursements meet beneficiary, medical necessity, practitioner-scope, documentation, and coding requirements • Determine root causes of billing errors, prevent recurrence, retrain on coding practices, and clarify policies and procedures • Provide timely overpayment refunds to payors in compliance with applicable requirements • Participate in coding reviews, monitoring, and internal audits • Stay current on coding, reimbursement, Medicare, Medicare Advantage, and regulatory changes • Ensure collections and A/R processes comply with federal and state regulations, protect patient information, and maintain financial integrity • Maintain and enforce a compliant billing and receivables framework that optimizes cash flow

🎯 Requirements

• Deep expertise with multi-state telehealth and in-person claim submission, copays, payment posting, insurance guidelines, and revenue cycle workflows • Deep expertise in Medicare and Medicare Advantage regulations surrounding telehealth practices and compliance • Exceptional communication skills to interact with patients, healthcare providers, and insurance companies • Unmatched attention to detail • Ability to manage multiple tasks and prioritize effectively • Ability to use multiple digital tools for billing, record keeping, and patient care directives • Degree, certificate, or diploma in medical billing, health information management, or healthcare administration preferred • Completion of a medical billing training program preferred • Certified Professional Biller (CPB) a major plus

🏖️ Benefits

• Remote work • Equal opportunity employment • No recruitment fees or requests for sensitive financial information during hiring

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