Revenue Cycle Manager/Direct Hire remote

Remote Position - Salary, Benefits and Bonus

Ideally this position would manage several teams to include separation of Medicare, Commercial, and DOL service lines. Experience in each of these service lines would be ideal.

MUST HAVE STRONG Hospice and Home Healthcare experience

Revenue Cycle Manager

• Supervision of Service lines including Medicare HH and Hospice, Commercial Contracts and Payers, DOL and Worker's Comp Programs
• Provide leadership and direction in all billing and collection processes.
• Provide ongoing training to billing staff related to software and regulatory changes, payor requirements, compliance, and department policies.
• Ensure all federal, state, and payor specific regulations and guidelines are adhered to.
• Manage the medical review process to ensure timely submission of documents to audit contractors.
• Develops and implements controls and measures to ensure accurate and timely billing and collections in accordance with established internal and third-party payor requirements (Medicaid, Medicare, MCO, Commercial payors). This includes the cycle from submitting claims to collection and denial management .
• Responsible for denials management of claims and performs root cause analysis to determine trends for denials and addresses the underlying issues on a timely basis including following third-party payor specific requirements for disputes, appeals and reconsiderations. Utilizes clearinghouse reports to ensure denials are addressed in a timely manner by the billing team
• Secures, maintains, and organizes managed care contracts including monitoring the terms and reimbursement criteria. Reviews and analyzes contracts routinely for financial profitability and to ensure the best interest to the agency.
• Develops, manages, and sustains relationships with third party payor representatives to communicate concerns and identify solutions. Coordinates with other internal operations including Credentialing, Clinical Support Team, Finance and Accounting, and Information Technology to ensure effective processes.
• Report on A/R aging at the weekly meeting including identifying issues that may need escalation. Provide monthly A/R aging summary for the CFO
• Responsible for managing the month end close process; work with clinical teams to ensure all transactions/revenue are captured; ensure all month end tasks are completed; generate the month end reports for finance; complete the month end reconciliation process.