Senior Revenue Cycle Claims Manager

Azalea Health; Atlanta (GA); On-site; USD 60,000 - 100,000; Full time

Job summary

An established industry player is seeking a Senior Revenue Cycle Claims Manager to lead a dynamic team in providing top-notch Revenue Cycle Management services. This pivotal role involves managing claims processes, ensuring compliance with billing regulations, and optimizing workflows for success. You'll act as a Subject Matter Expert, guiding clients and staff through complex claims issues while fostering a culture of collaboration and innovation. With a focus on continuous improvement and excellence, this position offers a unique opportunity to make a significant impact in a rapidly evolving healthcare landscape. Join a company that values your contributions and invests in your growth!

Benefits

Full medical insurance

Dental insurance

Vision insurance

Life insurance

Paid Time Off (PTO)

Qualifications

• 5-7 years of experience in Revenue Cycle Management or Healthcare Administration.
• Strong analytical and problem-solving skills with proficiency in analytics tools.

Responsibilities

• Manage a team of Claims Managers and oversee RCM Claims Specialists.
• Conduct audits to ensure claims quality and team productivity.

Skills

Revenue Cycle Management

Healthcare Administration

Analytical Skills

Problem-solving Skills

Customer Service

Education

Bachelor's degree in Business or Healthcare Operations

CPB or RH-CBS certification

Tools

EHRs

Analytics tools

Job description

IN SUMMARY...

The Senior Revenue Cycle Claims Manager provides Revenue Cycle Management/Medical Billing services for Azalea clients and operates under the direct supervision of the VP of Revenue Cycle Management or Director of Revenue Cycle Operations.

WHAT YOU WILL DO...

1. Demonstrate and maintain current knowledge of the Azalea Ambulatory application (Myrna System) for all functions related to RCM Billing and basic knowledge of billing guidelines pertinent to national standards.
2. Act as a Subject Matter Expert (SME) for clients, co-workers, and assigned staff as it relates to specific specialties, payers, claims related processes.
3. Accountable for a team of Claims Managers that oversee RCM Claims Specialists and assigned accounts.
4. Accountable for a Claims Advisory Specialist and maintaining quality audit practices.
5. Responsible for management, training, and supervision of RCM Claims Specialists, RCM Claims Team Leads and any RCM Department team members as assigned.
6. Responsible for reviewing employee timesheets, review and approve time off requests, and approve payroll for RCM Claims Team Leads and assigned RCM Claims Specialists.
7. Conducts One to One meetings with RCM Claims Specialists and Claims Team Leads.
8. Track and maintain monthly encounter volumes and unbilled encounter backlogs across all RCM accounts. Trends and proactively mitigates potential issues as they arise.
9. Conduct monthly internal audits to manage claims scrubbing quality assurance and team productivity.
10. Ensure that assigned RCM Claims staff workflows are optimized to reach successful performance benchmarks including but not limited to Avg Days to File, Avg Days to Bill, Claims Rejection Rates.
11. Deploy benchmarking techniques and data analysis to monitor employee productivity and performance KPIs.
12. Identify, analyze, and research frequent root causes of claim rejections, denials and backlogs.
13. Responsible for customer service communications and client escalations as it relates to complex claims issues such as backlogs, claim scrubbing, EDI rejections, and related denials and/or supporting Team Leads in such communications.
14. Support new RCM client onboarding and account set up as needed; Effectively manages claim specific software and clearinghouse settings and configurations on behalf of RCM clients per department standard operating procedures.

BACKGROUND AND SKILLS YOU WILL BRING...

1. Bachelor's degree in Business, Healthcare Operations or related field.
2. CPB or RH-CBS certification highly preferred.
3. 5-7 years of experience in Revenue Cycle Management and/or Healthcare Administration required with a minimum of 2 years of experience in a supervisory capacity.
4. 6+ years of progressive coding and billing experience.
5. Rural Health Care Billing knowledge & experience strongly preferred.
6. Demonstrated knowledge and application of billing, reimbursement and compliance regulations.
7. Strong analytical and problem-solving skills and proficient in analytics tools.
8. Prior experience with EHRs, or health information technology strongly preferred.

SUCCESS LOOKS LIKE...

1. Being aggressive and taking initiative; we trust you to move the needle forward.
2. Doing the job; outcomes are just as important as strategy.
3. Being adaptable and amenable to meet the changes of a dynamic and evolving industry.
4. Demonstrating humility; partnership and collaboration is who we are and how we operate.
5. Tapping into your innovative side; conventional is not always correct.

HOW WE INVEST IN YOU...

1. Competitive and comprehensive benefits: Coverage options to support the whole person, including full medical, dental, vision, and life insurance.
2. Balance and flexibility: Simple Paid Time Off (PTO) options. You earn your time, use it as you choose.
3. Economic opportunity: Competitive total rewards package that offers competitive pay and advancement opportunities.

Azalea Health's EEO Statement

Azalea Health is an Equal Opportunity Employer committed to creating a diverse and inclusive workforce where our employees excel based on merit, qualifications, knowledge, ability, and job performance. We embrace and encourage our employees' differences in age, color, disability, ethnicity, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socioeconomic status, veteran status, and any other characteristics protected by federal, state, and local laws that make our employees unique.