Specialty:Accounting & Finance
Excellent Healthcare Company Looking for a Revenue Manager
This individual will act primarily as a billing expert but will be expected to do other revenue cycle duties across multiple clients. The ideal candidate will have above average knowledge of medical billing procedures and practices. Tasks include: ensuring the accurate and timely submission of medical claims received from providers to various health plans, employers and worker comp carriers for expeditious reimbursement and optimal provider satisfaction.
Our ideal candidate will possess:
An understanding of the healthcare revenue cycle process, specifically as it relates to billing of health plans, employers and workers comp. Understanding of claim edits, and work with BPOs strong plus. The ability to navigate and operate within multiple systems. The skills to effectively manage billing processes as well as multitask with AR follow-up, posting, and other revenue cycle functions as needed.
A qualified individual will require the ability to interact with multiple clients and departments in a professional and collaborative manner. This position is part of a high functioning, high performing, project driven team. The ability to multi-task is essential. A high level of accountability is essential.
- Set claims to scrub and correct unclean claims
- Distribution of claims to the payers for prompt, efficient reimbursement
- Includes filing paper and electronic claims
- Report claims filing activity
- Work with employer invoicing and workers comp carriers
- Ensure claims are sent with payers with sufficient documentation
- Reporting unclean claims
- Report and document abnormal claim filing occurrences and trends
- Identify and pro-actively resolve claims issues with internal and external customers
- Maintain appropriate records for area(s) of responsibility.
- Work closely with Provider Auditor and Leadership Team to answer provider inquiries
- Retrieve any data needed for claims filing from client, such as price of charges
- Completes any other delegated tasks as assigned by manager as it relates to the overall revenue cycle process
- High school diploma
- 5-7 years experience in medical billing and collections including facility and physician
- Understanding of NCCI edits and application of modifiers
- Computer systems and applications experience, must have working knowledge of Word, Excel, e-mail, and internet
- Strong analytical skills with the ability to assess and analyze trends to determine the most effective approach to bill
- Detail oriented
- Critical thinking skills
- Problem solving
- Knowledge of medical terminology, experience with ICD9 and 10, CPT codes
- Experience dealing with workers comp, managed care plans, Medicare, Medicaid, and Employer paid accounts
- Ability to perform multiple tasks simultaneously
- Excellent customer service skills
- Self-motivated and assertive with strong organizational skills
- Excellent written and verbal communication skills