Job Opening for a Reimbursement Manager/Revenue Cycle Management located in San Jose, California.
- Ideal candidate will have experience working with 3rd party billing companies (ie. Quadex); Commercial (UnitedHealthcare, Blue Cross, etc.) & government (ie. Medicare, etc.) billing knowledge
- Must have flexibility to be onsite daily while training and building out the team; there is flexibility to occasionally work remote following training and hiring of team
- Direct management/supervisory experience
The main purpose of the role is to manage revenue cycle activities. Major areas of focus include, but may not be limited to, oversight of a third party billing agent, audit of accounts receivables and reconciliation against revenue expectations, and management of staff. The incumbent will work closely with professionals within the broader organization, including commercial, market access, life cycle and finance staff. He/she will actively participate in strategic planning, continuous improvement activities as well as vendor management relating to revenue cycle requirements.
Serving as an expert in revenue cycle management, the incumbent will be available to support engagements with internal stakeholder and support strategy development for the enterprise, including best practice in billing, strategic contacting, revenue optimization and compliance. Necessarily, he/she will be required to maintain strong understanding of rules, regulations and coding conventions likely to impact the organization. He/she will work in close collaboration with staff representing Finance, Sales/Marketing, Market Access & Reimbursement, Life Cycle Leadership, Legal/Compliance and ensure performance through positive external vendor relationships.
- Oversee revenue cycle operations for molecular diagnostic laboratory
- Develop and implement policies and procedures to ensure the organization’s revenue cycle metrics are achieved. Metrics include, but may not be limited to: timely billing, charge capture, cash receipts, payment posting, bad debt, days in accounts receivable, contact and revenue expectations
- Ensure compliance with Federal, State and company requirements associated with HIPAA, HITECH and patient privacy requirements
- Deliver timely market insights and trends affecting revenue, receipts and payments trends relating to market segments, insurance and self-pay accounts
- Leads a team and performs supervisory responsibilities including hiring decisions, performance management, compensation, and employee development
- Collaborates with team and other managers to achieve strategic objectives and to ensure quality services and compliance with relevant contractual and regulatory requirements
- Bachelor’s Degree in Accounting or other business-related field or equivalent combination of education and work-related experience.
- 8+ years of direct experience in revenue cycle management for health care providers within the U.S.
- Direct experience working with health care billing systems and software
- Experience leading a collaborative team
- Demonstrated ability in the development, management and successful deployment of policies, procedures and performance metrics relating to billing, coding, payment and vendor management activities
- Excellent written and verbal communication skills, proficiency with the English language, and an ability to effectively influence internal and external stakeholders in a positive manner
- Ability to multi-task and work in a fast paced, high volume environment
- Exquisite attention to detail
Preferred Job Qualifications:
- Certified professional coders by the AAPC or AHIMA
- Experience in laboratory, diagnostics, hospital, clinical or allied care services
- Experience in the development and distribution of tools, messages and programs that offer compliant education directed toward internal and external customers
Competitive Salary Range!
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