Revenue Cycle Operations Manager

4 weeks ago


Wailuku, Hawaii, United States LHH Recruitment Solutions Full time
Position Overview

LHH Recruitment Solutions is in search of a Revenue Cycle Operations Manager. This position is essential for overseeing the denial management division within our organization.

We are looking for a skilled and knowledgeable RCM Operations Manager to lead our team in effectively managing claim denials. Your expertise will play a vital role in safeguarding the financial stability of our organization while navigating the intricate landscape of healthcare reimbursements.

Key Responsibilities:
  • Direct and mentor the denial management team to proficiently handle and resolve claim denials, ensuring adherence to healthcare agreements and minimizing revenue loss.
  • Leverage your comprehensive understanding of healthcare agreements to accurately interpret payment terms and conditions, providing essential guidance to your team.
  • Guide the team in identifying and resolving payment challenges by investigating root causes and implementing corrective measures.
  • Ensure that all denial management activities align with compliance regulations, maintaining accurate and thorough documentation.
  • Collaborate closely with external auditors, supplying necessary documentation and clarifications related to denial management and financial compliance.
  • Proactively address remittance challenges, adapting to shifts in the healthcare environment to ensure timely and precise payment postings.
  • Analyze denial patterns and payment discrepancies, leading the team in identifying improvement opportunities and executing effective solutions.
  • Maintain open and effective communication with internal teams, external auditors, and healthcare payers to resolve issues and enhance processes.
  • Continuously assess and refine denial management processes to boost efficiency and accuracy, while mentoring your team to adopt best practices.
Qualifications:
  • A minimum of 5 years of experience in denial management, claims processing, and revenue cycle operations, with a strong understanding of healthcare agreements and compliance standards.
  • At least 1 year of experience in a leadership capacity.
  • Proficiency in healthcare information systems and software utilized for claims processing and denial management.
  • Strong analytical skills to identify trends, investigate issues, and develop solutions.
  • Thorough knowledge of compliance regulations and external audit requirements.
  • Excellent problem-solving abilities to effectively address payment issues and remittance delays.
  • Strong communication skills for interaction with internal teams, external auditors, and healthcare payers.
  • Demonstrated ability to lead and mentor a team, fostering a collaborative and productive work environment.
  • Capacity to adapt to changes in the healthcare landscape and manage remittances effectively.

Work Schedule: Onsite | Monday to Friday | 7am-4pm | Contract to hire

Compensation: $30.00 to $36.00 per hour

Benefits: Our associates enjoy a range of benefits including medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits, and a 401K plan. We offer flexibility in choosing coverage that meets individual needs, along with eligibility for paid leave and holiday pay where applicable.

Equal Opportunity Employer: We are an equal opportunity employer and welcome applications from all qualified individuals.



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