Oncology RCM Supervisor: Billing & Denials Lead

OneOncology; United States; À distance; USD 80 000 - 95 000; Plein temps

Résumé du poste

OneOncology is seeking a Remote RCM Shared Service Supervisor to lead daily RCM operations for partnered practices. You will oversee charges auditing, coding accuracy (ICD10/HCPCS/CPT), AR management, and authorizations workflows to ensure timely payments and client satisfaction.

The role requires 3+ years in healthcare RCM, oncology billing experience, and strong leadership with a focus on process improvement and KPI achievement.

Qualifications

• Strong knowledge of medical terminology and procedures related to Oncology/Hematology.
• Excellent communication skills, both verbal and written.
• Ability to work collaboratively with a diverse group of individuals, including physicians, patients, insurance providers, and pre-authorization teams.
• Strong organizational and time management skills.
• Ability to work independently and manage multiple priorities in a fast-paced environment.
• Proficiency in medical billing software and other computer programs used for record keeping and data analysis.
• Knowledge of Windows-based software applications. (E.g.: Word, Excel, Outlook...)
• Minimum of 3 years of experience in healthcare RCM required, preferably in an Oncology healthcare setting.
• Prior management experience preferred.
• Project management preferred.
• Expertise in insurance policies and regulations related to medical billing, including Medicare and Medicaid #LI-REMOTE

Responsabilités

• Assist staff in auditing and posting charges when necessary.
• Assist with proper selection of ICD10, HCPCS, and CPT codes.
• Work with practice to resolve any issues with interface files.
• Monitor accounts receivable for all Oncology services provided to patients.
• Oversee authorizations training staff and maintaining up to date knowledge of coverage guidelines related to drug, lab, procedure, and imaging authorizations.
• Manage coverage and benefit workflows including triaging insurance code requests for maintenance of the practice management system.
• Follow up with insurance companies to ensure timely payment of claims related to shared service lines.
• Investigate and assist in resolving any outstanding insurance and patient balances related to shared service lines of business including claim rejections, denials, and appeals.
• Review and interpret insurance policies and regulations related to shared services to ensure compliance with billing and collection requirements.
• Work collaboratively with the practices to ensure accurate and complete billing is received timely.
• Maintain accurate and up-to-date records of collections activities in patient files and computer systems.
• Monitor and track claims through the denial process to ensure timely payment and identification of payer roadblocks.
• Stay current with industry trends, changes to insurance policies, and other developments that may impact the collections process.
• Monitors and assesses business metrics to refine processes and improve efficiencies including benchmarking.
• Prepare reports for clients and leadership related to performance and productivity.
• Prepare payroll records and maintain employee attendance/audits for HR payroll processing.
• Manage employee activity such as hiring, job performance, evaluations, and disciplinary actions with appropriate approvals as required.
• Lead team meetings and prepare minutes for distribution to team and management.
• Other duties as assigned to help drive our mission of improving the lives of everyone living with cancer.

Connaissances

Medical billing

Oncology billing

Revenue cycle

Leadership

Communication

Description du poste

OneOncology is seeking a Remote RCM Shared Service Supervisor to lead daily RCM operations for partnered practices. You will oversee charges auditing, coding accuracy (ICD10/HCPCS/CPT), AR management, and authorizations workflows to ensure timely payments and client satisfaction.

The role requires 3+ years in healthcare RCM, oncology billing experience, and strong leadership with a focus on process improvement and KPI achievement.