Senior Manager of Revenue Cycle Services

2 weeks ago

Carlsbad, New Mexico, United States Advanced Heart and Vascular Center of New Mexico, LLC Full time
Job Overview

Position: Director of Revenue Cycle Management

We are seeking a highly skilled and efficient leader in healthcare revenue cycle management to supervise all activities related to the revenue cycle department. The responsibilities of the revenue cycle director encompass identifying patient reimbursement challenges, ensuring the effective processing of claims, denials, and appeals, as well as resolving billing-related concerns.

To excel in this role within our cardiovascular practice, you should be adept at managing both staff and patient inquiries. A successful revenue cycle director will consistently seek opportunities to enhance the operations of the revenue cycle department.

Key Responsibilities:
  • Establishing a robust system to guarantee accurate billing information is entered into the billing platform.
  • Overseeing account management, liaising with insurance providers, handling collections, cash posting, contract analysis, and billing.
  • Possessing comprehensive knowledge of regulatory requirements pertaining to patient accounting, including a thorough understanding of Medicare, Medicaid, and managed care processes.
  • Evaluating financial hardship applications.
  • Demonstrating the ability to work autonomously to achieve objectives, often in the absence of established precedents or assistance.
  • Effectively addressing patient complaints related to billing and collections.
  • Developing and maintaining departmental policies and procedures, ensuring clear communication of relevant information to other departments.
  • Implementing controls and review mechanisms to ensure adherence to established procedures.
  • Ensuring compliance with applicable regulations, standards, and directives from regulatory bodies and third-party payers.
  • Maintaining extensive knowledge of revenue cycle and regulatory requirements associated with governmental, managed care, and commercial payers.
  • Maximizing the collection of payments and reimbursements for medical services from patients, insurance carriers, financial aid, and guarantors.
  • Collaborating with operations to review and enhance processes related to insurance verification, coding review, billing, collection, and payment posting for optimal efficiency and best practices.
  • Monitoring aged accounts and verifying that appropriate collection procedures are being implemented.
  • Working with Managed Care vendors to identify any payer relationship issues or contracts that require negotiation.
  • Performing other duties as assigned.
Qualifications:
  • Bachelor's degree in finance, business administration, healthcare administration, or a related field, or a minimum of 5 years of experience in Revenue Cycle Management.
  • Certification as a Medical Biller/Coder.
  • Proficiency in Microsoft Office applications and medical office software.
  • Demonstrated experience in healthcare billing within an Ambulatory Surgery Center or complex cardiovascular office setting.
  • Strong understanding of health insurance providers.
  • Excellent interpersonal and organizational skills.
  • Outstanding customer service abilities.
  • Capability to thrive in a fast-paced environment.
  • Knowledge of compliance standards.
  • Preference for experience with Athena and Ambulatory Surgical Center or Office Based Lab Billing/EMR.

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