AR Manager - Revenue Cycle
Reporting Structure: Sr. Director of Billing / Reimbursement
General Summary: Responsible for co-management of the the daily claims and appeals functions within Biotheranostics Inc. billing/reimbursement team. Provide management and leadership to Team Members of the Revenue Cycle functional departments and provide management and coordination of the Third-Party Billings to ensure they are operating effectively and efficiently. Areas of oversight include: Claims Submission, Appeals Management, External Appeals, Payor Trends, Payor Analytics. Focus on maximum reimbursement, compliance with regulatory and company policies. Working with billing support vendors to streamline the daily operations, with other healthcare agencies. Partner with other related Biotheranostics Inc. departments and their various stakeholders effectively. Improve processes by SOP and workflow redesign, cost benefit analysis, technical solutions, and special projects.
The following are intended to be examples of the accountabilities for which the person in this position would be responsible. This list is not intended to be complete or all-inclusive and does not preclude management from assigning other or related functions or projects for which the individual has demonstrated competency through performance.
- Oversee and support the day to day activities of claims submission and appeals functions and their related teams' members
- Manage and drive tasks and processes to resolution by having a thorough knowledge of the billing revenue cycle, including claims denials/appeals process, cash posting and payor contract compliance.
- Provide technical expertise and problem solve complex issues
- Prepare statistical reports for Sr. Management and Chief Financial Officer.
- Conduct Payor analytical reporting, ie. Payor trends, Payment Trends, and Denial Management
- Manage account receivables with foresight to meet cash goals.
- Track department productivity, quality, and prepare management reports for account receivables in adherence to department standard metrics.
- Identify, develop, and implement revenue cycle workflow, process improvements, system implementation, testing and production protocols.
- Lead all functional areas within A/R, remedy any impacted A/R by providing timely and compliant solutions.
- Support the management team in their efforts of mentoring and develop training initiatives and goal setting to improve overall communication, leadership, effective writing, coaching and other characteristics.
- Design, develop and implement Standard Operating Procedures (SOP) along with maintaining document control protocol.
- Support the Manager/Leads in their efforts to plan and prepare work schedules and assign team duties.
- Manage time and attendance for staff as well as implement disciplinary and corrective actions, approve/deny time off requests, conduct performance reviews, address complaints and resolve problems.
- Provide escalation for supervisors and department members to resolve account issues.
- Maintain strictest confidentiality; adheres to all HIPAA guidelines/regulations.
- Uphold Medicare, Medicaid, and HIPAA compliance guidelines in relation to billing, collections, and PHI information.
Remain aware of evolving needs and opportunities, showing flexibility in doing whatever is appropriate to support the Company's success. Pursue educational opportunities to maintain advanced and up-to-date knowledge in the field. Perform all other related duties as required and assigned and understands that the items in this description are not all- inclusive.
- High School Diploma or GED minimum requirement. Associates degree or higher highly preferred.
- At least five to seven years' supervisory experience in the healthcare/biotech billing arena
- Experience in billing data entry, collections, appeals processes
- Experience in Medicare and Commercial claims data processing
- Understand and interpret 837/835, RARC/CARC coding and formats
- Experience in following HIPPA guidelines
- Prior experience in overseeing day to day operations and leading a staff
- Have a working familiarity with a LIS Lab System and technologies
Skills / Knowledge / Abilities
- Strong analytical skills
- Excellent oral and written communication skills.
- Excellent project management and organization skills
- Ability to effectively lead a team and to foster a positive and productive work environment
- Well suited to working in a fast-paced environment
- Must be detail-oriented as well as comprehend the big picture
- Knowledge of basic medical coding and third-party operating procedures and practices.
- Ability to operate a computer and basic office equipment.
If interested, please submit a copy of your CV/Resume to us to apply.E-mail