Sr. Manager – Revenue Cycle Management

Sr. Manager – Revenue Cycle Management

Requirements

• High School Graduate, Medical Office training certificate or relevant experience
• 5+ years experience in managing physician revenue cycle
• 3+ years experience in management of personnel
• Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims
• Must comply with HIPAA rules and regulations

Responsibilities

• Oversee the entire claims submission and follow-up process, ensuring claims are submitted accurately and on time
• Lead and manage large payer projects and care center support projects, updating leadership and affected stakeholders as needed
• Keep ADs abreast of opportunities for improvement in daily operations along with recommendations on process improvements
• Management of the teams accountable for the accounts receivable (AR) including analysis and resolution of the aged AR, looking for root cause issues
• Utilize data to identify patterns in claim denials or delays and develop actionable solutions to address them
• Independent decision making regarding claim adjustments, resubmission, appeals, and other claim resolution techniques
• Makes policy updates as needed, to all RCM policies
• Meets with the Performance Operations, Implementation, Sales and other Privia teams, review escalated issues and discuss payer or claim concerns
• Meets with Care Center leadership including the lead physician partners, office managers and other staff to discuss complex claim or other revenue cycle matters
• Responsible for training internal teams (Operations, Sales) as well as care center staff when appropriate
• Support care center go lives as needed, which may include overnight travel
• Laser focused drive toward achievement of department’s daily and monthly KPIs, requiring a team focused approach to attainment of these goals
• Responsible for performing or assisting with duties related to staffing to include hiring, termination, coaching and training
• Provides ongoing feedback to subordinate staff regarding of performance throughout the year to subordinate staff
• Counsels employees in disciplinary matters and obtains assistance from human resources appropriately for disciplinary actions and/or employee termination process
• Other duties as assigned

Preferred Qualifications

• Strong preference for experience working with athenaOne, Trizetto and SalesForce
• Experience with Florida providers and payers preferred