RCM Senior Manager
Revenue Cycle Management
- Posted: 12 August 2021
- 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, Havasu Eye Center, 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!
RCM Senior Manager - Business Systems and Acquisition
American Vision Partners - Phoenix Admin (Biltmore), travel to all other AVP current and future locations
The RCM Senior Manager - Business Systems and Acquisition will be responsible for day-to-day operations of the RCM teams related to acquisitions. Directs and coordinates the overall functions related to the revenue cycle to ensure maximization of cash flow, while improving patient, physician, customer relations and accounts receivable for newly acquired acquisitions. Works to identify any potential opportunities to increase automation through the use of EDI transactions or third party applications that improves RCM process efficiency and/or reduces cost with existing vendor partners. Responsible for development and oversight of RCM training teams and curriculum.
- Manages the day to day operations of the A/R Department to maximize cash flow by managing all aspects of the insurance billing and third party collections while ensuring adherence to department policies and procedures.
- The RCM Systems Senior Manager is the departmental liaison with all vendors, including but not limited to, clearinghouses, contracted business partners, third party payers, and information systems.
- Provides project management, coordination, implementation, education, training, and oversight to approved RCM projects including but not limited to practice management system upgrades and RCM functions related to acquisitions.
- Provides oversight for RCM training teams and ensures that optimal training curriculum is in place at all times and that training material is up to date.
- Analyzes month end reports to identify opportunities for process improvements with respect to claims denials and outstanding A/R.
- Identify any potential opportunities to increase EDI transactions with clearinghouses or business partners. Actively research and inquire any technology or product offering that improves RCM process efficiency and/or reduces cost with existing vendor partners.
- Reviews and trends insurance denials to identify root cause and provide recommendations on workflow modifications and denial resolution.
- Work with users to optimize the use of automated and manual systems within the RCM environment
- Monitors and identifies processes to be implemented in order to achieve key revenue cycle metrics including but not limited to Unbilled A/R, Denials as a Percent of Charges, Cash Collections, Aging over 90 Days, and Days in AR.
- Identifies trends and issues impacting billing efficiency and performance.
- Provides regular feedback and escalates issues when appropriate.
- 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.
- Consistently reviewing billing work queues on a regular basis to ensure that workloads are evenly distributed and that department goals are being met.
- Communicate regularly with payers and know when and how to appropriately escalate issues for resolution.
- Maintains comprehensive knowledge of payer billing requirements and reimbursement policies.
- Conducts regular meetings with staff. Provides direction to staff on changes in reimbursement or payer guidelines.
- Remain knowledgeable on all HIPAA electronic transactions including claims (837), remits (835), eligibility (270/271), and claim status (276/277) Identify opportunities for implementation of HIPAA transactions
- Other duties as assigned.
Education and Experience:
- Minimum five years in a leadership role within a healthcare revenue cycle department.
- Previous supervisory experience with strong leadership skills and an ability to motivate others with a positive attitude.
- Leadership capability and proven successful experience in managing medium to large A/R teams.
- Experience working in Excel (advanced formulas, pivot table), PowerPoint, Word and Outlook.
- High school diploma or GED required. BA/BS in Business Administration, Account, Finance or equivalent is preferred.
Essential Skills and Core competencies:
- Excellent written and verbal communication and presentation skills.
- Excellent critical thinking and analytical skills.
- Excellent interpersonal skills including conflict management.
- Well organized and demonstrated ability to meet deadlines.
- Strong Knowledge of Medicare, Medicaid and Commercial payer guidelines.
- Working knowledge of cpt, hcpcs and diagnosis coding.
- Demonstrated ability to multi task and work well under pressure.
- Demonstrate a high level of subject matter expertise in functional area to bridge business requirements and IT solutions; provide technical direction and ensure compliance with best practice solutions.
- Ability to analyze and interpret information and to prioritize and re-prioritize as necessary.
- Comprehensive knowledge of HIPAA Rules & Regulations.
Benefits & Perks:
Your health, happiness and your future matters! At AVP, we offer everything from medical and dental to significant eye care discounts, continuing education, 401(k), 9 paid holidays plus PTO, flexible work hours 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.