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We're seeking a Revenue Cycle Manager (RCM) who excels at working withpeople from diverse backgrounds and thrives on connecting and collaborating across multiple teams .This role will lead the establishment of the RCM function and then go on to leads a revenue cycle team within the billing department that handles claim submissions, payment posting, and denials & appeals and manages staff actives (outsourced and internal) through daily supervision while overseeing the functional areas across the revenue cycle.
Qualifications• Bachelor's Degree is required• Minimum of 5 years of RCM experience in healthcare. Laboratory setting is strongly preferred.• Extensive knowledge of reimbursement, billing, coding, and compliance regulations is required. Scaling new heights in neurological testing. • Experience with managing teams, including supervision of staff that process claims submissions, payment posting, and/or denials & appeals management.• Experience managing outsourced RCM vendors preferred• Strong problem-solving skills and ability to resolve complex inquiries across multiple databases.• Confidence and professionalism in handling interactions via calls, email, or messaging.• Ability to engage in complex analysis and discuss with upper management.• Strong interpersonal skills.• Strong organizational skills and attention to detail.
Responsibilities• Manage the entire process from insurance verification to final collection.• Coordinate and manage outsourced RCM resources while the company is scaling and help to build out an internal team over time.• Liaison with internal departments to promote ongoing communication and collaboration on cross-functional projects related to submission and denials of claims.• Partner with the Senior Vice President of Market Access to perform: Provider Credentialing and Enrollment with government and commercial payers, Payer Contract Administration, and Payer Analytics• Partner with company Controller to analyze reimbursement from all sources, including carrier reimbursement exception reporting, follow-up, pending claims analysis, and denial management.• Responsible for the Timely, accurate submission of all claims for service to the responsible payer.
Personal Characteristics• Mission driven to serve patients and those who care for them in a caring and compassionate manner• Highly driven, thrives in a meritocratic environment• Team oriented• High ethical standards
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