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Manager, Revenue Cycle

1 month ago

Nashville TN United States Integrated Oncology Network Full time

Come join our team of highly motivated, passionate, individuals who center their efforts around learning and delivering trusted revenue cycle expertise for our patients' journey. We are seeking a leader who is passionate about building relationships, inspiring others, and leading successful teams who drive successful outcomes. This RCM Manager role is focused on patient advocacy ensuring every patient in our care has the necessary financial clearance prior to services. Requirements for this leader include extensive knowledge of insurance eligibility, payer guidelines and brings subject matter expertise in authorization management

Job Purpose:

The Manager is responsible to develop and implement consistent guidelines and staff development for verifying and determining patients eligibility for insurance benefits and securing any necessary prior authorizations for treatment for all medically necessary services and ensuring access for all patients.

Essential Functions:

· Develop, document, and implement best practice workflows for the daily operations of all benefit eligibility coordinator and authorization coordinator staff and Team Leads.

· Ensure curriculum and technology is well understood by staff and utilized appropriately.

· Responsible for VOB and Authorization denials management by root cause analysis and coaching

· Manage all preservice denials and appeals

· Monitors, tracks, and analyzes staff productivity

· Direct all STAT or pending orders waiting on authorizations

· Maintain reporting to ensure there are minimal claims holding due to authorization needs.

· Intervenes in crisis situations - quickly and independently discerning interventions required - using sound analysis, professional judgment, ethical practice, and common sense.

· Work closely with providers, patient navigators, front office staff and clinical staff to ensure smooth patient access.

· Lead monthly check in meeting with all staff members both individually and in group setting to review performance and establish goals moving forward.

· Completes all performance evaluations, delivers coaching and disciplinary action and performance improvement plans.

· Work closely with training team for new hire onboarding.

· Create training policies for VOB and authorization training workflows

· Deliver monthly KPI's to manager on time for prior month.

· Assist with organization initiatives to support integrations for new provider partners

· Manage and approve all team member timecards, PTO, etc.

· Regular attendance and punctuality.

· Performs other duties as assigned.

Qualifications and Education Requirements

· Ability to work a flexible schedule as necessary.

· Three or more years' experience in patient access management specifically responsible for authorizations, verification of benefits, denails and/or appeals.

· Working knowledge of medical terminology as well as ICD-9 and CPT codes.

· Strong written/verbal communication skills.

· Strong competency of Microsoft Word, Power point and Excel

· Associates Degree or an equivalent combination of education and experience.

· Travel required - 30% to various locations with-in the enterprise.

Required Competencies

Excellent judgment, dependability, conscientious performance. Detail oriented. Exceptional interpersonal and communication skills. Caring and empathic. High ethical standards. Mechanical ability and manual dexterity for operating complicated equipments.

Physical Demands and Work Environment

The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

_Physical demands: _While performing the duties of this job, employee is required to walk; sit; use hands to handle, or feel objects, tools, or controls; reach hands and arms; talk and hear. Employee must lift and/or move 50 pounds. Specific vision abilities required by the job include close vision, distant vision, color vision, peripheral vision, depth perception, speech clarity, climb, balance, and stoop, kneel, and bend.

_Work environment: _While performing the duties of this job, the employee is exposed to environmental risk of radiation exposure, and biohazard exposure.

Job Type: Full-time

Schedule:
* 8 hour shift
* Day shift
* Monday to Friday

Experience:
* EHR systems: 2 years (Required)
* Relationship building: 3 years (Required)
* Revenue Cycle Management: 3 years (Required)
* Critical thinking: 3 years (Required)

Ability to Relocate:
* Nashville, TN 37205: Relocate before starting work (Required)

Willingness to travel:
* 25% (Required)

Work Location: In person