|Skills:||billing,leadership,personnel management,leading,building teams,healthcare,managing claims
|Preferred Certifications:||CPM,CPC,CPMA or similar certification,CPCO
|Required Experience:||8 to 10 years
|Preferred Experience:||8 to 10 years
Summary of Major Responsibilities
The Manager, Revenue Cycle is
responsible for leading the team and driving the strategies of the entire
revenue cycle process of a clinical independent lab with integrity and quality.
This position requires an extensive understanding of and experience with the
medical billing process, Medicare compliance, payer audits, and the independent
lab industry and personnel The Manager, Revenue Cycle is responsible for
communicating the health of the department to leadership teams via meetings,
conference calls, presentations and reports. The role also requires strong
skills and experience in personnel management, leading and building teams to
foster a culture grounded by the core values of integrity, teamwork,
innovation, and quality
Essential Duties and Responsibilities
- Develops and maintains all
revenue cycle department’s priorities, procedures, and policies for Exact
- Determine appropriate and
effective performance metrics and staff requirements for the department to
run with efficiency and accuracy while providing outstanding customer
- Develops processes and
procedures for the efficient and successful flow of interdependent
information between the third-party billing vendor, the receivables
department and Exact Sciences contact center.
- Designs and execute key
strategies and infrastructures to drive collection of earned reimbursement
for lab operations.
- Develops processes and policies
for exception handling, appeals and denials and balance billing.
- Monitors all client accounts
receivable activity and performance and initiates appropriate corrective
measures as needed.
- Investigates denial sources,
trends, resolves and appeals with cross-functional team involvement.
- Monitors billing compliance
with all third-party payer regulations.
- Ensures that customer
satisfaction, via all personnel, is achieved through courteous and
effective communication, problem solving and efficient processes.
- Oversees and manages the daily
performance of the revenue cycle department and all accounts receivable
- Motivates team on month end
goals and metrics. Reports on month end activity to key leadership.
- Promotes and demonstrates a
team-oriented environment that fosters effective collaboration within and
outside of the department.
- Monitors all departmental
processes to ensure compliance with performance metrics and relays this to
leadership in a timely, effective manner.
- Hires, coaches, inspires and
motivates team; Implements and monitors staff productivity and service
performance metrics and reports this to leadership.
- Maintains confidentiality in
compliance with HIPAA regulations and ensures that department remains
compliant with all relevant regulations.
- Implements and assists with
innovative staff education programs.
- Supervise staff including but
not limited to organize and prioritize work, write/conduct performance
reviews, train/develop, and manage work performance.
- Apply deep familiarity with
payer/insurance appeals and reimbursement processes, experience working in
the insurance industry and professional billing.
- Apply knowledge and
familiarization with the Medicare billing regulations, compliance, and
reimbursement methodologies especially in the laboratory environment.
- Apply knowledge of third-party
billing service provider (i.e. Xifin, Epic) or revenue cycle management
software and outsourced billing organizations.
- Apply strong analytical and
forecasting skills with demonstrated ability to plan workload, allocate
tasks and scale operations to align with business priorities.
- Oversees and implements staff
reporting and building key productivity and accuracy metrics.
- Apply strong organizational and
- Apply adaptable, open to change
and able to work in ambiguous situations and respond to new information
and unexpected circumstances.
- Utilize strong interpersonal
and teamwork skills including the ability to easily convey concepts and
priorities as well as ability to solicit feedback and inputs.
- Utilize strong presentation
skills with ability to convey information and adjust delivery as
appropriate to the audience.
- Ability to inspire and motivate
others and work effectively through influence and collaboration.
- Support and comply
with the company’s Quality Management System policies and procedures.
- Regular and reliable
- Ability to work normal schedule
of Monday through Friday during normal business hours.
- Ability to work in front of a
computer screen and/or perform typing for approximately 80% of a typical
- Bachelor’s degree in healthcare
administration, business or related field; or high school degree/general
education diploma and 4 years of relevant experience in lieu of degree.
- 8+ years of experience working
in the medical/healthcare billing area, with strong, demonstrated
knowledge of managing claims processing.
- 5+ years of leadership
experience with demonstrated ability to recruit, assess, motivate &
inspire others to help business achieve success.
- Authorization to work in the
United States without sponsorship.
- Demonstrated ability to perform
the Essential Duties of the position with or without accommodation
- Leadership in accounts
receivable or billing operations.
- Experience working in both
payer billing and provider billing operations in a laboratory.
- CPC, CPM, CPCO, CPMA or similar
- Membership in any of the
patient accounting organizations (i.e. AHAM)