Job Summary
Our healthcare organization seeks a Revenue Cycle Management leader to oversee account receivables and collections. Responsible for providing managerial and administrative oversight of the Revenue Cycle Management Department. We are looking for a medical billing expert, so applicants should have 3-5 years of experience in a medical billing office as well as a bachelor's degree. In this role, you will coordinate our billing and collection activities, maximizing payments and improving our processes. You must also ensure compliance with HIPAA and other relevant healthcare regulations.
Do you have what it takes to drive results and break through the Commercial Insurance Plan Quagmire to ensure proper claim reimbursement? If so keep reading
Job description
You will oversee all tasks and personnel assigned to the Revenue Cycle Management (RCM) department. Possess extensive medical billing and coding knowledge and thoroughly understand all facets of RCM. RCM Manager will identify client reimbursement issues, ensure that claims, denials, collections, and posting are efficiently processed, and resolve billing-related issues for multiple Commercial Health Plan Insurance and Private Pay.
You will hire a team of collectors; restructure reporting systems, set collector daily and monthly collection targets, and add any other resources needed to implement an effective and efficient RCM department. This position requires an innovative person to implement Best Practices in the RCM processes, yielding high collection rates based on the client’s health plan policies.
DUTIES AND RESPONSIBILITIES:
Include, but are not limited to:
- Implement an RCM system to ensure that accurate billing information is entered, and clean claims are submitted.
- Supervise the RCM department in various duties such as; billing, account management, communications with insurance providers, collections, appeals, cash posting, billing transactions with clients and report creation.
- Conduct client and health plan providers analysis and take corrective action as necessary to ensure the RCM department meets agreed to goals and targets.
- Monitoring and resolution of denials - including root cause, resolution, re-submission of claim, claim acceptance, and payment receipt
- Verify eligibility and authorization details as needed.
- Work with Commercial Health Plans as needed to resolve billing issues.
- Work on appeals and special projects as needed.
- Works with other departments (Clinical, Utilization Review, Finance, etc.) on resolving any billing issues timely and efficiently.
- Runs reports (A/R aging, collections, write-offs, etc.) regularly and meets with direct supervisor weekly to review the status and progress of the RCM process.
- Manages staff performance using metric-driven reports and provides regular feedback, performance reviews, and one on one meetings.
- Oversees the hiring and training of staff.
- Correctly coding diagnoses and procedures.
- Planning and structuring the department workflow and staffing.
- Ability to meet deadlines and adjust to changing priorities.
- Builds trusting relationships with internal and external customers by providing confident leadership and timely communication
- Mentors and provides staff with day-to-day guidance and assistance
- Manage /Oversee all Payment Posting
- Abide by HIPAA guidelines.
Skills/Experience in :
- Computer skills in Windows-based applications.
- CRM
- Photocopy, fax machines, and voicemail.
- EHR/EMR systems
- Clearinghouse Claims Experience
- Billing platform, Avea, Collaborate MD preferred.
QUALIFICATIONS:
- Must have a Bachelor’s degree in finance or business administration or a combination of relevant work experience.
- At least three years of experience as an RCM Manager in the Behavior Health, Substance Abuse Disorder field, Private Pay, and Commercial Health Insurance Plans. Proficient working knowledge with Blue Cross Blue Shield in the state of Texas.
- Proficiency in using Windows OS, web-based programs, and Microsoft Office Suite.
- Working Knowledge of ICD-10 and coding.
- At least 5 to 7 years of experience using EHR/EMR systems and billing platforms (Collaborate MD preferred).
- The ability to work accurately and independently.
- Good verbal and written communication skills.
- Excellent analytical skills and an eye for detail.
- Outstanding leadership and managerial skills.
- Strong time and people management skills.
- Ability to work to strict deadlines.
- Must be fluent in English
Job Type: Full-time
Job Type: Full-time
Pay: $80,000.00 - $100,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Flexible schedule
- Health insurance
- Paid time off
- Vision insurance
Schedule:
Supplemental pay types:
Work Location: Hybrid remote in Fort Worth, TX 76104