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CPC Revenue Cycle AR Manager
1 month ago
Ensures activities of CBO billing operations are conducted in a manner that is consistent with overall department billing protocols, and are in compliance with Federal, State, and payer regulations, guidelines, and requirements. Implements and monitors adherence to the organization's billing, collection, and refund policies and procedures.
Reviews, and assesses Revenue Cycle activities and functions by interpreting operational data to assess need for procedural revisions and enhancements; participates in the design and implementation of specific systems to enhance revenue and operating efficiency.
Participates in monthly Department Administrator and Operations meetings, Revenue Cycle meetings, as appropriate to provide data and feedback on Revenue Cycle operations management. Prepares regular and ad-hoc reports and presentations to support meeting agendas.
Promotes effective communications between Central Business Office personnel, Front-End staff, and Department Administrators to ensure ongoing education/training and expedite problem resolution.
Supports company, group, and department financial analysis. Provides feedback and works directly with Clinic sites with support from practice managers and Market Directors to develop and implement action plans for improving operations and business-related functions impacting billing and reimbursement needed to identify and manage challenging Revenue Cycle processes and problem payors.
Assists and participates in creation of training manuals and job aids for respective area(s) of expertise and responsibility.
Conducts change readiness assessments, evaluates results and presents findings in a logical and easy-to-understand format.
Participates in new service/business line research and assessment and provides business and analytical support for the reporting and research of existing and potential opportunities for revenue enhancement.
In conjunction with the Revenue Cycle Director and Supports Complete Health's growth efforts, clinical initiatives, and development of new markets by assuring provider and system setups and tablespace expectations are delivered timely.
Requirements: MINIMUM REQUIREMENTS Bachelor's degree preferred.
Certified Professional Coding Certificate from AAPC o
At least 5 years of experience in healthcare Revenue Cycle required.
Knowledge related to accounts receivables, billing systems performance, coding, A/R reporting, and revenue management analysis.
2-3 years Management experience in Practice Management or Revenue Cycle Management Preferred.
Experience with physician billing in primary care setting preferred.
Advanced knowledge of third-party insurance, and familiarity with insurance plan types; HMO, PPO, POS, and Indemnity.
Excellent knowledge and understanding of EHRs and Physician Billing Systems. Athena experience preferred.
Excellent knowledge of the Commercial, Medicare, HMO, and PPO Programs particularly as it relates to CPT procedures and ICD-10 diagnostic coding and billing. Thorough knowledge of Medicare Fraud and Abuse regulations.
Ability to counsel patients financially regarding outstanding charges and effectively resolve problems exhibiting the highest customer service skills and etiquette.
Excellent knowledge of HIPAA regulations.
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