Revenue Cycle Manager

3 weeks ago

Milwaukee, United States Novir Full time
About This Role:

As a Revenue Cycle Manager at Novir, you will oversee all aspects of the revenue cycle process as it relates to medical billing and reimbursement. This role requires a detail-oriented individual with strong analytical skills, a deep understanding of revenue cycle operations, and the ability to collaborate across departments to achieve financial objectives. We're looking for someone who has a strong knowledge of insurance coding, credentialing, and who has a track record of resolving billing issues.

What You'll Do:
    • Manage the entire revenue cycle process, including patient registration, coding, billing, collections, and accounts receivable management
    • Identify opportunities to streamline revenue cycle workflows, enhance operational efficiency, and reduce revenue leakage through continuous process improvement initiatives
    • Ensure compliance with regulatory requirements, coding guidelines, and payer policies to minimize denials and optimize reimbursement
    • Oversee the timely submission and processing of claims, monitor claim status, and coordinate appeals as necessary to resolve claim denials and ensure prompt payment
    • Collaborate with internal stakeholders, including clinical departments, finance, and IT, to optimize revenue cycle processes, resolve issues, and achieve financial objectives
    • Research, verify, update, and assures the accuracy of information into the medical billing system
    • Submits claims to insurance companies with an understanding of the correct medical codes to use
    • Be an expert in the insurance denials, rejections, and appeals process and maintaining records of disputing and resolved claims
    • Reviews medical claims to determine if some or all expenses should be billed to Medicare, Medicaid, insurance companies, or other agencies and corresponds and follows through with agencies to ensure funds are collected
    • Drive credentialing process with providers for new state expansion
    • Manage expansion of Novir to new states, standing up all necessary accounts with state insurance, Medicare, Medicaid, private insurance, and other agencies.
    • Conducts audits as needed to resolve problems from misapplied funds
    • Comply with all applicable HIPAA policies and procedures and maintain confidentiality
Experience We're Looking For:
    • Minimum of 5-7 years of progressive experience in revenue cycle management, with at least 3 years in a leading revenue cycle operation
    • Experience working in a self-directedfast-paced start-up environment with minimal supervision
    • Strong understanding of revenue cycle processes, including billing, coding, reimbursement, and accounts receivable management, preferably in a healthcare setting
    • Excellent analytical and problem-solving skills, with the ability to analyze financial data, identify trends, and develop data-driven strategies to improve revenue cycle performance
    • In-depth knowledge of healthcare regulations, billing requirements, coding guidelines (e.g., ICD-10, CPT), and payer policies to ensure compliance and maximize reimbursement
    • Proficiency in revenue cycle management systems, electronic health records (EHR), billing software, and other relevant technologies to support revenue cycle operations and data analysis
    • Working knowledge of Waystar, TransactRX,preferred.
    • Bachelor's degree in healthcare administration, Business Administration, Finance, or related field. Master's degree preferred.
Preferred Experience:
    • Certifications in revenue cycle management (e.g., Certified Revenue Cycle Professional - CRCP) or healthcare finance (e.g., Certified Healthcare Financial Professional - CHFP)
Who You Are:
    • You're Thorough - You are willing to do the research where needed, and always close the loop when solving problems
    • You're Analytical: You understand systems and billing and can critically review the data you are entering for accuracy
    • You're Curious - You are always looking to grow professionally, and pass that curiosity on to team mates
    • You're A Strong Communicator: You are comfortable communicating with clients and internal team members clearly and concisely

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