Revenue Cycle Manager
4 weeks ago
Experience, qualification, and soft skills, have you got everything required to succeed in this opportunity Find out below.
What’s in it for you?
Competitive Salary
GENEROUS time-off package 21 Days off (15 PTO Days and 6 Paid Holidays) Accrues on Day One (PTO policy rewards longevity with increases each year)
Competitively priced health plan, vision and dental, partially employer paid
Company paid short and long-term disability and life insurance (up to $50,000 in coverage)
401K with employer match
Career advancement opportunities
Proactive Health Management Wellness Program (PHMP)
A brief overview of Responsibilities:
Manage the Revenue Cycle: Oversee all aspects including medical records, billing, coding, collections, denials, authorizations, and quality assurance.
Vendor and Payer Relationships: Manage relationships with external software vendors and clearinghouses, and communicate professionally with various payers.
Staff Management and Training: Mentor revenue department staff and provide ongoing education on coding trends and regulations, including OASIS updates.
Billing Policies and Compliance: Develop, implement, and revise billing, coding, and reimbursement policies while adhering to HIPAA and regulatory compliance.
Financial Reporting and Reconciliation: Reconcile receivables and revenue, collaborating with finance for monthly reports and maintaining the billing database based on CMS fee schedules.
Credentialing and Enrollment: Oversee credentialing processes and manage enrollment or re-enrollment with Medicaid, Medicare, and commercial payers.
Claims and Collections Management: Resolve billing issues, monitor collections, evaluate third-party reimbursements, and ensure accurate claim processing.
Compliance and Strategic Planning: Stay updated on reimbursement policies, maintain internal controls, and develop strategies for improving billing practices and revenue management.
Other duties as assigned
Qualifications:
3–5 years of related management experience
Knowledge of third-party payer requirements, including federal, state, and private healthcare plans and authorization processes
Proven experience in healthcare billing, including Medicaid/Medical Assistance
Understanding of insurance policies, reimbursement practices, Medicare coding, and OASIS guidance
Expertise in process development and execution
"James River is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status."
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