RCM Billing Manager

3 weeks ago

Phoenix, United States American Vision Partners Full time

Company Intro:

At American Vision Partners (AVP), we partner with the most respected ophthalmology practices in the country and integrate best-in-class management systems, operational infrastructure, and advanced technology to provide the highest quality patient care possible. Our practices include Barnet Dulaney Perkins Eye Center, Southwestern Eye Center, Retinal Consultants of Arizona, M&M Eye Institute, Abrams Eye Institute, Southwest Eye Institute, Aiello Eye Institute, Moretsky Cassidy Vision Correction, Wellish Vision Institute, West Texas Eye Associates and Vantage Eye Center. We are focused on building the nations largest and most comprehensive eye care practices and currently operate more than 100 eye care centers in Arizona, New Mexico, Nevada, California and Texas including 25 ambulatory surgical centers.

At AVP we value teamwork, providing exceptional experiences, continuous improvement, financial strength, and hard work. We are committed to providing best-in-class patient care, pioneering research and technology, and most importantly, rewarding and recognizing our employees

Overview:

The A/R Manager will be responsible for day-to-day operations of the Insurance A/R follow up and denial management, cash application and credits, coding and authorizations teams . Directs and coordinates the overall functions related to the revenue cycle to ensure maximization of cash flow, while improving patient, physician, customer relations and outstanding accounts receivable. Oversees large insurance follow up A/R team with the support of supervisory staff.

Responsibilities:
  • Manages the day to day operations of the A/R Department to maximize cash flow by managing all aspects of the insurance billing and third party collections while ensuring adherence to department policies and procedures.
  • Analyzes month end reports to identify opportunities for process improvements with respect to claims denials and outstanding A/R.
  • Routinely reports out key performance indicators to leadership and manages team accordingly to ensure targeted metrics are met.
  • Reviews and trends insurance denials to identify root cause and provide recommendations on workflow modifications and denial resolution.
  • Monitors and identifies processes to be implemented in order to achieve key revenue cycle metrics including but not limited to Unbilled A/R, Denials as a Percent of Charges, Cash Collections, Aging over 90 Days, and Days in AR and other revenue cycle metrics as assigned.
  • Oversees teams productivity audits, track problematic trends and compiles statistical data on a monthly basis.
  • Manages supervisory staff and ensures that productivity and accuracy audits are being performed, department policies are followed and administered fairly.
  • Identifies trends and issues impacting billing efficiency and performance.
  • Provides regular feedback to the Director and Vice President of RCM and escalates issues when appropriate.
  • Review and approve adjustments and refunds.
  • Resolve complex payer or physician issues when necessary. Act as a primary point of contact for clinical operations for day to day operational issues relating to billing, collections and denials.
  • Oversees the hiring, training, and supervision of department staff. Ensures that department policies are fairly administered by overseeing corrective action process, employee training, mentoring and coaching employees and supervisors as well as completing performance reviews.
  • Consistently reviewing practice management work queues on a regular basis to ensure that workloads are evenly distributed and that department goals are being met.
  • Communicate regularly with payers and know when and how to appropriately escalate issues for resolution.
  • Communicates performance data and action plans to leadership.
  • Maintains comprehensive knowledge of payer billing requirements and reimbursement policies.
  • Conducts regular meetings with staff. Provides direction to staff on changes in reimbursement or payer guidelines.
  • Keeps abreast of changes in billing regulations.
  • Research and resolve discrepancies in a timely manner.
  • Works with sensitive information and must be able to exercise discretion.
  • Must be able to travel to newly acquired practice to perform training, process mapping and system integrations up to 25% of the time.
  • Other duties as assigned.


Qualifications:

Education and Experience:

  • Minimum five years in a leadership role within a healthcare revenue cycle department.
  • Previous management experience with strong leadership skills and an ability to motivate others with a positive attitude.
  • Leadership capability and proven successful experience in managing large A/R follow up teams.
  • Demonstrated experience managing to key performance indicators including experience routinely reporting metrics and managing a team to meet defined metric based goals.
  • Advanced ability working in Excel (advanced formulas, pivot table), PowerPoint, Word and Outlook.
  • Experience working with NextGen practice management is preferred.
  • High school diploma or GED required. BA/BS in Business Administration, Account, Finance or equivalent is preferred.

Essential Skills and Core competencies:

  • Excellent written and verbal communication, presentation skills and conflict management.
  • Excellent critical thinking and analytical skills.
  • Well organized and demonstrated ability to meet deadlines.
  • Strong Knowledge of Medicare, Medicaid and Commercial payer guidelines.
  • Working knowledge of cpt, hcpcs and diagnosis coding.
  • Demonstrated ability to multi task and work well under pressure.
  • Ability to analyze and interpret information and to prioritize and re-prioritize as necessary.
  • Comprehensive knowledge of HIPAA Rules & Regulations
Benefits & Perks:

Your health, happiness and your future matters At AVP, we offer everything medical and dental insurance, significant eye care discounts, child care assistance, pet insurance, continuing education funds, 401(k), paid holidays plus PTO, Sick Time, opportunity for growth, and much more

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