Senior Revenue Cycle Leader (Healthcare)

Fulgent Genetics; Coppell (TX); On-site; USD 120,000 - 180,000; Full time

Job summary

Inform Diagnostics, a Fulgent Genetics Company, is seeking a Senior Manager, Revenue Cycle Management to lead coding, data entry, billing, accounts receivable, and reimbursement activities for the team. You will ensure timely, accurate, and compliant filing and foster collaboration across departments.

The role requires maintaining current payer information, implementing policy changes, and overseeing vendor relationships and training to improve operational performance and KPI metrics.

Qualifications

• Bachelor's degree in business administration, healthcare or related field.
• Ten years billing experience in a healthcare environment and 7 years of progressive leadership experience.
• Knowledge of Revenue Cycle Management functions, including, but not limited to Data Entry, ICD-10 Coding, Accounts Receivable Management, and Remittance Application.
• Knowledge of medical Anatomical Pathology is a plus.
• Proficient in Microsoft Office Suite, specifically Word, Excel, and Outlook, and general working knowledge of Internet for business use.
• Ability to work in a fast-paced, deadline driven environment.
• Drive for Results (Service, Quality, and Continuous Improvement) Ensure procedures and processes are in place that lead to delivery of quality results and continually reassess their effectiveness to achieve continuous improvement.
• Proficient verbal and written communication skills. Willingness to share and receive information and ideas from all levels of the organization in order to achieve the desired results.
• Commitment to the successful achievement of team and organizational goals through a desire to participate with and help other members of the team.
• Customer Service Focus Demonstrate a focus on listening to and understanding client/customer needs and then delighting the client/customer by exceeding service and quality expectations.

Responsibilities

• Build and oversee the full RCM Integrity program, from patient services to claims submission and collections, ensuring compliance with Payor & ASCP requirements.
• Conduct standard RCM risk assessments and audits across inhouse & offshore practices to identify potential areas of vulnerability and implement corrective action plans as needed.
• Advise senior leadership on matters involving billing integrity, regulatory compliance, and financial risk management.
• Develop, document, and implement approved revenue cycle policies, procedures, and workflows that align with federal and state regulations, payer contracts and reporting requirements.
• Acts as administrator for payor portals & EDI connectivity with Third Party Payors.
• Remain current with changes in reimbursement regulations.
• Collaborates with management on operational performance and changes needed in the operation. Notifies and trains staff on significant coding and billing changes.
• Gather and review reimbursement data, analyzes results, prepares report and oversee the resolution of any identified issues.
• Train clinicians, sales, and billing department staff.
• Assist with the selection, training, and performance evaluation of supervisors and staff.
• Plan, direct, and supervise coding, data entry, billing, and collections supervisors and staff to ensure timely, accurate, and complete processing of services while ensuring all quality and production goals are met.
• Resolve employee relations issues and recommends disciplinary action when required.
• Focus on improving all KPI metrics.

Skills

Leadership experience

Communication skills

Customer service focus

Drive for results

Education

Bachelor's degree in business administration, healthcare or related field

Tools

Microsoft Office Suite

Job description

Inform Diagnostics, a Fulgent Genetics Company, is seeking a Senior Manager, Revenue Cycle Management to lead coding, data entry, billing, accounts receivable, and reimbursement activities for the team. You will ensure timely, accurate, and compliant filing and foster collaboration across departments.

The role requires maintaining current payer information, implementing policy changes, and overseeing vendor relationships and training to improve operational performance and KPI metrics.