Position Summary / Scope of ResponsibilityFunctions as a floating Revenue Cycle leader by providing interim management coverage, operational support, special project leadership, and hands-on claims assistance across multiple RCM teams as organizational needs dictate.
Primary ResponsibilitiesThe incumbent may be asked to perform job-related tasks other than those specifically stated in this description. The duties and responsibilities of the position are to be carried out in a manner that is consistent with the Mission, Core Values and Operating Principles of MedVanta.- Serves as primary point of contact for the Divisions regarding front-end revenue cycle matters.
- Ensures a good understanding of services provided by Divisions and how these services are accurately billed to payers.
- Supports operations as appropriate in calls or face-to-face meetings with Divisions to resolve reimbursement issues.
- Works collaboratively with coding and compliance departments to ensure providers receive appropriate training and feedback.
- Manages the overall Accounts Receivable function and team.
- Oversees and streamlines billing and collection processes.
- Performs special program and billing planning and implementation.
- Ensures healthcare facilities are reimbursed for all procedures.
- Handles information related to patient treatment, diagnosis, and procedures to ensure proper coding.
- Investigates insurance fraud and reports findings as appropriate.
- Reviews A/R reports to ensure claims are paid by insurance carriers or patients in a timely manner.
- Provides leadership coverage and operational oversight for other Revenue Cycle Management teams during manager absences, vacancies, or periods of increased operational need.
- Supports cross-functional Revenue Cycle departments by serving as a flexible management resource to ensure continuity of operations and team performance.
- Leads and participates in special projects, process improvement initiatives, and strategic assignments as directed by the Vice President of Revenue Cycle Management.
- Collaborates with leadership on departmental initiatives focused on operational efficiency, reimbursement optimization, workflow enhancements, and staff support.
- Assists with claims follow-up, resolution, and other revenue cycle operational activities during periods when project work or management coverage responsibilities are limited.
- Performs hands-on revenue cycle functions as needed to support departmental productivity goals and organizational priorities.
- Performs all other duties as assigned.
REQUIREMENTS AND COMPETENCIESRequiredEducation and Experience- Bachelor's degree in Business, Finance or related discipline preferred.
- 5+ years of related manager-level experience, with experience in an orthopaedic setting preferred.
- Certified Professional Coder (CPC) preferred.
- Proficiency with Microsoft Office suite of products as well as practice management and electronic health record systems.
- Extensive knowledge of insurance, benefits, medical terminology, and medical billing.
- Experience working with billing and accounts receivable for both commercial and non-commercial payors.
- Demonstrated experience in leadership and supervision, as well as financial management and resource allocation.
- Knowledge of multiple coding systems, including Level 1 HCPCS and Level 2 HCPCS.
Competencies / Required Skills and Abilities- Strong interpersonal skills - ability to develop relationships and collaborate and influence in a centralized organization.
- Demonstrated ability to organize, prioritize, and manage multiple tasks in a dynamic environment with a proven track record of results.
- Strong interpersonal, oral, and written communication skills with excellent self-discipline and patience.
- Able to work independently.
- Exudes professionalism in presentation.
- Must be able to read, write, speak, understand, and communicate in the English language.
Physical Demands - Must be able to sit for long periods of time and lift up to 25 pounds.
- Must be able to use appropriate body mechanics techniques when performing desk duties.
- Requires frequent bending, reaching, repetitive hand movements, standing, walking, squatting, and sitting.
- Adequate hearing to perform duties in person and over telephone.
- Must be able to communicate clearly to patients in person and over the telephone.
- Visual acuity adequate to perform job duties, including reading materials from printed sources and computer screens.
