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Revenue Cycle Operations Supervisor

2 months ago

Indianapolis, Indiana, United States Pinnacle Healthcare Consulting LLC Full time
Job Overview

Position Title: Accounts Receivable Manager

Company: Pinnacle Healthcare Consulting LLC

Employment Type: Full-Time

Salary Range: $55,000 - $67,000

Benefits Offered: Comprehensive Medical, Dental, Vision, Short-Term and Long-Term Disability, Health Savings Account (with employer contribution), and a 401k Plan with employer matching.

Pinnacle Healthcare Consulting LLC specializes in Revenue Cycle Management (RCM) services, providing professional billing solutions for independent medical practices. We pride ourselves on fostering a collaborative work environment that values hard work and dedication.

Key Responsibilities:
  • Oversee and manage the performance of assigned personnel, including attendance tracking, payroll management, training, and performance evaluations.
  • Ensure that team productivity, quality, and compliance meet established company standards.
  • Provide ongoing motivation and training to enhance staff capabilities.
  • Identify and address issues and discrepancies, implementing corrective actions as necessary.
  • Act as a liaison between upper management and team leads regarding revenue cycle matters.
  • Facilitate communication between clients and relevant professional organizations, including vendors and credentialing contacts.
  • Stay updated on payer bulletins and disseminate relevant information to staff and management.
  • Develop training materials for various job functions, ensuring team proficiency in all required systems and resources.
  • Conduct training sessions for new and existing employees on job responsibilities and company policies.
  • Participate in the workflow of subordinates to enhance productivity and address challenging tasks.
  • Interpret and communicate work procedures and policies to team members.
  • Handle escalated customer inquiries and complaints regarding policies and procedures.
  • Provide recommendations to upper management on staffing and procedural improvements.
  • Assist in recruiting, interviewing, and selecting new staff with support from human resources.
  • Create work schedules aligned with budgetary constraints and workload demands.
  • Design and evaluate training and development programs for staff, focusing on customer service and performance metrics.
  • Monitor compliance with confidentiality policies in accordance with HIPAA regulations.
  • Complete tasks assigned by the Director in a timely manner.
  • Communicate any issues that may impact deadlines or revenue to the Director.
  • Identify opportunities for enhancing organizational performance within the revenue cycle.
  • Participate in or lead assigned administrative projects.
Essential Functions:

Summary: Provide comprehensive support across the Accounts Receivable Department as needed, including verifying insurance and obtaining necessary referrals/authorizations for procedures while overseeing daily operations.

Essential Duties:
  • Generate daily, weekly, and monthly reports for management review regarding insurance eligibility and referral statuses.
  • Oversee special projects assigned to the eligibility and referral teams.
  • Develop and implement new procedures to enhance productivity and maintain quality standards.
  • Effectively communicate policies to team members and ensure compliance with company standards.
  • Continuously monitor client schedules for eligibility verification.
  • Review work queues and reports for adverse trends, prioritizing tasks for resolution.
  • Conduct Root Cause Analysis for denial trends and assist in process redesign to minimize avoidable denials.
  • Communicate non-covered services to the Director for further research and policy development.
  • Monitor non-contractual adjustments to identify trends and take appropriate actions.
  • Ensure Accounts Receivable Specialists are trained to perform essential tasks, including understanding payer explanations of benefits and updating patient information.
  • Assign Accounts Receivable Specialists to assist Customer Service Representatives with complex account resolutions.
  • Provide adequate coverage for Customer Service Representatives in alignment with client time zones.
Qualifications:
  • Preferred: Associate's Degree in Medical Billing and Coding or a related field.
Experience and Skills Required:
  • 5-10 years of experience in a medical billing office or similar environment.
  • Comprehensive understanding of the revenue cycle, including customer service, charge entry, cash applications, accounts receivable, credentialing, and coding.
  • Knowledge of government and managed care payment methodologies, including terms like contractual adjustment and denial processes.
  • Proficient in ICD10 and CPT Coding.
  • Familiarity with HIPAA laws and regulations, ensuring compliance.
  • Strong attention to detail for accurate information management.
  • Excellent skills in Microsoft Suite, particularly Excel, Word, and Outlook.
  • Demonstrated analytical skills.
  • Ability to communicate initiatives and results effectively to various management levels and clients.
  • Current knowledge of medical professional claims processing, payment posting, collections, and accounts receivable follow-up.

Direct Reports: Accounts Receivable Specialists

Acting Manager for Coverage: Accounts Receivable Specialists