Hours of Work :40
Days Of Week :Mon-Fri
Work Shift :Job Description :Your Job:
The Manager in this role is responsible for the oversight of AR Specialist and a Team Lead. Setting and achieving performance goals by fostering teamwork, effective communication and moving conflict to collaboration within the Central Business Office. Monitors and improves all efforts to reduce accounts receivables according to goals established by MHS Administration. Monitors quality of work and proactively reviews trends and variances that may delay reimbursement. Works with the Director to prioritize departmental initiatives to develop, implement, monitor, and communicate annual goals and objectives. Understanding and knowledge of budgets and performance standards for the area of responsibility in order to evaluate opportunities for cost saving and quality improvement. Interacts with Human Resource including hiring, training, coaching, counseling for employees in the area of their responsibility.
Your Job Requirements:
- Education: Bachelor's degree in Healthcare Administration, Business, or related field required. Master's preferred.
- Experience: 5+ years in physician billing, revenue cycle management, or payer relations; 3+ years of direct leadership experience.
- Knowledge Base: In-depth understanding of CPT/HCPCS/ICD-10 coding, payer-specific requirements, and CMS guidelines for physician services.
- Systems: Epic experience required; experience with denial management systems and reporting tools preferred.
- Certifications: Certification through HFMA, AAHAM, or Epic (PB Resolute or Claim Edit) preferred for new hires; encouraged for incumbents.
Your Job Responsibilities:
- Leads all post-bill follow-up and denial resolution activities across all payers, ensuring timely resolution and maximum reimbursement for multi-specialty physician services.
- Directs the appeals and reconsideration process, including root cause analysis, persuasive appeal writing, and submission accuracy.
- Collaborates with Revenue Integrity and Coding teams to ensure accurate documentation, reduce revenue leakage, and ensure compliant charge capture.
- Oversees Epic workqueue utilization, provides optimization feedback, and partners with IT to support performance improvement.
- Manages a team of AR staff (including one Team Lead), focusing on team coaching, performance monitoring, productivity tracking, and staff development.
- Conducts denial trend analysis and leads cross-functional discussions to resolve clinical, documentation, or billing workflow barriers.
- Supports AR goals, denial recovery metrics, and process improvement initiatives in partnership with the Director of Physician Revenue Optimization.
- Participates in enterprise revenue cycle meetings, peer manager forums, and professional development efforts.
- Contributes to cultural engagement, team-building initiatives, and talent development in alignment with Methodist Health's leadership standards.
Work Arrangement:
Hybrid - Onsite 2 days per week or as required by leadership.
