Certified Patients Account Manager/Revenue Cycle Representative

GENNTE Technologies; Dover (DE); On-site; USD 85,000 - 130,000; Full time

Job summary

GENNTE Technologies in Dover, Delaware seeks a seasoned leader to direct staff in insurance AR management, ensure compliant billing, and drive improvements in denials and collections. You will collaborate with Employed Physician Practices, Revenue Cycle, and other departments to uphold internal controls and meet accreditation requirements.

The role requires 5+ years in patient accounting with 3+ in leadership, plus strong communication and reporting skills.

Qualifications

• Five years in patient accounting or related field, including at least three years in a supervision/leadership role.
• Bachelor's degree preferred; high school diploma or GED with 8 years of Revenue Cycle Progressive leadership experience acceptable.
• Experience with third-party reimbursement and payer rules/regulations.

Responsibilities

• Supervise the assigned team, including interviewing, hiring, performance evaluation, training and disciplining staff.
• Set goals and establish procedures; monitor financial and operational performance; audit, trend and benchmark billing and collection.
• Manage Accounts Receivable for insurance AR to minimize losses; ensure adherence to payor rules and internal policies.
• Complete monthly rounding on direct reports; maintain rounding logs and stop light reports; promote engagement and continuous improvement.
• Monitor insurance credit balances and resolve discrepancies.
• Review QA results with staff and provide education to address opportunities.
• Contribute to education materials for new hires and annual training competencies.
• Prepare and communicate AR performance reports for large payers; escalate issues to State/Federal agencies as needed.
• Maintain Epic ARCR certifications; ensure access to Medicare Novitasphere and Medicaid portals.
• Review system change requests for payer/process impact; validate supporting documentation.
• Handle access requests and maintenance inclusive of relevant portals.
• Perform all other duties within scope of responsibilities.

Skills

Leadership

Revenue Cycle

Accounts Receivable

Epic HB/PB

Communication

Education

Business

High School Diploma or GED with 8 years Revenue Cycle Leadership

Tools

Epic AR

Medicare Novitasphere

Medicaid portals

Job description

Responsible for directing, coordinating, and planning of staff for insurance AR, to ensure efficient and proper billing, account follow-up, account collections, and reconciliation of patient accounts. Must work collaboratively with Employed Physician Practices, Revenue Cycle, and other relevant departments to ensure compliant billing. Adhere to internal controls for applicable state/federal laws, and the program requirements of accreditation agencies and federal, state, and private health plans. Leads by example, upholding all facility values and holding team members and payers accountable. Ability to work independently and meet established deadlines, develop reports, and quantify denial issues impacting AR performance. Excellent communicator and agent for change.

Responsibilities

1. Supervises the assigned team and team members engaged in the department. This includes interviewing, hiring, performance evaluation, training and disciplining all system support personnel. Delegates tasks as determined appropriate.

2. Provides a goal-oriented work environment, establishing clear and concise work procedures expectations. Develops and plans goals and objectives for the department with PFS Leadership Team. Measures financial and operational performance, maintains monitoring and reporting systems. Audit, trend and benchmark billing/collection functions.

3. Manage Accounts Receivable for all insurance AR billed in the Epic HB and PB modules to minimize financial losses to facility. Ensures adherence to all governmental and commercial payor rules, regulations, and Facility Corporate policies and procedures. Ensures that accounts receivable activities are meeting productivity, quality, reimbursement goals and all reimbursement options have been exhausted. Monitors vendor performance, as appropriate for any insurance AR vendors. Review and respond to patient complaints, legal documents following appropriate customer services, and internal policies.

4. Complete monthly rounding on direct reports; maintain individual rounding logs and stop light reports to facilitate communication. Promotes employee engagement for individual teams and the department striving for continues improvement.

5. Responsible for monitoring performance and resolution of all insurance credit balances.

6. Reviews quality assurance review results with staff providing as necessary education/training to address opportunities for improvement.

7. Contributes to development of education materials for new hire and annual training competencies

8. Monthly reporting requirements: AR performance for large payers, physician practices, and vendors. Communicates performance issues and actions being taking to resolve the issues. As appropriate escalates to State and Federal agencies when payers are not adhering to regulations.

9. As applicable, maintains all Epic ARCR certifications in good standing.

10. Reviews all requests for system changes to determine the impact on payers and processes under the position’s span of control. Ensures supporting research and documentation supporting the change request are accurate and have been properly validated.

11. Responsible for access requests and maintenance including, but not limited to Medicare Novitasphere and Medicaid portals.

12. All other duties as assigned within the scope and range of job responsibilities.

Required Education, Credential(s) and Experience

• ; Business
• ; In lieu of a bachelor’s degree, will accept a High School Diploma or GED with eight (8) years of Revenue Cycle Progressive leadership experience (Four years of experience for a verified associate’s degree.)

Experience: Required: Five years in patient accounting, third-party reimbursement, or related field, to include a minimum of three (3) years of experience in a supervisor or leadership role.

Preferred

Seven years in patient accounting, third-party reimbursement, or related field, to include a minimum of five (5) years of experience in a supervisor or leadership role.