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Revenue Cycle Billing Manager (RCM) - Phoenix (Biltmore)

Revenue Cycle Management

  • Posted: 22 August 2022
  • Full-time
  • Phoenix, AZ, USA

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, and Moretsky Cassidy Vision Correction. We are focused on building the nation’s largest and most comprehensive eye care practices and currently operate more than 100 eye care centers in Arizona, New Mexico, 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!

Billing AR Manager - Phoenix (Biltmore)

American Vision Partners - RCM Corporate Office

The A/R Manager will be responsible for day-to-day operations of the revenue cycle management. Manages 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 coding, insurance verification and patient customer service teams for assigned regions. 

RESPONSIBILITIES:

  1. Manages the day to day operations of the assigned teams to maximize cash flow by managing all aspects of claim coding, payer authorizations and patient customer service.
  2. Manage the team that answers specific coding questions and approves coding for specialty surgeries.
  3. Manage the team that carefully reviews and corrects any charges posted by clinic staff on a daily basis.
  4. Manage the team that posts any additional clinic and surgical charges as needed on a daily basis.
  5. Manages the team that follows the established industry standard and CMS coding guidelines to ensure proper billing of charges. This includes CPT-4 and ICD codes as well as modifiers.
  6. Analyzes month end reports to identify opportunities for process improvements with respect to coding claims denials and authorizations.
  7. Routinely reports out key performance indicators to leadership and manages team accordingly to ensure targeted metrics are met.
  8. Reviews and trends insurance denials related to coding and authorization to identify root cause and provide recommendations on workflow modifications and denial resolution.
  9. Monitors and identifies processes to be implemented in order to achieve key revenue cycle metrics including but not limited to unbilled A/R, patient balance collections and authorizations.
  10. Oversees team’s productivity audits, track problematic trends and compiles statistical data on a monthly basis.
  11. Manages supervisory staff and ensures that productivity and accuracy audits are being performed, department policies are followed and administered fairly.
  12. Identifies trends and issues impacting billing efficiency and performance.
  13. Provides regular feedback to senior RCM leadership and escalates issues when appropriate.
  14. Review and approve adjustments and refunds.
  15. 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, patient collections and authorization for assigned region.
  16. 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.
  17. Consistently reviewing practice management work queues on a regular basis to ensure that workloads are evenly distributed and that department goals are being met.
  18. Communicates performance data and action plans to leadership.
  19. Maintains comprehensive knowledge of payer billing requirements and reimbursement policies.
  20. Conducts regular meetings with staff. Provides direction to staff on changes in reimbursement or payer guidelines.
  21. Keeps abreast of changes in billing regulations.
  22. Research and resolve discrepancies in a timely manner.
  23. Works with sensitive information and must be able to exercise discretion.
  24. Other duties as assigned.

QUALIFICATIONS

Education and Experience:

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

Essential Skills and Core competencies:

  1. Excellent written and verbal communication, presentation skills and conflict management.
  2. Excellent critical thinking and analytical skills.
  3. Well organized and demonstrated ability to meet deadlines.
  4. Strong Knowledge of Medicare, Medicaid and Commercial payer guidelines.
  5. Working knowledge of cpt, hcpcs and diagnosis coding.
  6. Demonstrated ability to multi task and work well under pressure.
  7. Ability to analyze and interpret information and to prioritize and re-prioritize as necessary.
  8. 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!

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.