Medicare/Medicaid Revenue Cycle Manager

Enjoy problem-solving, need a venue to display your creativity, and emerging technologies pique your interest; if so, Barrow Wise Consulting, LLC is for you. As a multi-disciplined leader, you understand the gifts that set you apart from everyone else. Demonstrate innovative solutions to our clients. Join Barrow Wise Consulting, LLC today.

Responsibilities:

The Medicaid/Medicare Revenue Cycle Manager will support Barrow Wise's Illinois DHS project and perform the following duties:

• Manage the entire revenue cycle process, including billing, coding, collections, and denial management
• Monitor the accuracy and efficiency of patient billing information
• Review and resolve issues related to claim generation and rejected/denied billings
• Communicate professionally with various payers, including Medicare
• Implement coding changes and provide coding education to clinical and coding/billing staff
• Provide day-to-day supervision, development opportunities, training, and mentorship
• Increase reimbursements and provide revenue optimization
• Conduct monthly analysis of Medicare and Medicaid
• Develop and execute process improvements related to revenue cycle management
• Optimize cash flow, minimize bad debt, and improve overall financial performance
• Provide and manage consulting, data transfer, and claims processing services to increase federal revenues in Medicare A, B, D, and Medicaid in IDHS State Operated Facilities
• Provide revenue maximization services for Medicare A, B, D, and Medicaid
• Enhance billing and coding accuracy, claims management, eligibility verifications, regulations, and compliance with recommendations and implementation of training, new systems, processes, and automation
• Provide and manage services to process Medicare D claims and collection as required by Federal Medicare D rules and requirements; ensure a streamlined and compliant billing and collection function, including an electronic accounts receivable system specific to pharmacy claiming
• Review and assess the current Medicare Part A & B, Medicaid, claiming policies, procedures, practices, and outcomes of each State-operated facility for mental health and developmental disabilities
• Assist the State with billing Medicare Part A & B and Medicaid programs; provide IDHS with detailed information identifying those claims that the vendor submitted in an agreed-upon format and frequency
• Assist the State in the completion of annual Medicare cost reports by reviewing Medicare cost report schedules to ensure reports are completed appropriately and maximize Medicare and Medicaid cost reimbursement
• Implement processes to improve billing and claiming with the transition to State staff
• Provide recommendations as to the level and expertise necessary for individuals to conduct billing and claims to achieve optimal revenue
• Develop and deliver training, documents, manuals, and other resources required to promptly identify and correctly bill for eligible individuals served by the DHS State-Operated Facility programs
• Work as a mediator between the State and the Fiscal Intermediary NGS (National Government Services), which requires them to answer questions related to the Medicare cost reports, billings and claims
• Assist the IDHS Office of Fiscal Services with the submission of Medicare bad debt claiming
• Assist the IDHS Office of Fiscal Services with the submission of annual Medicare cost reports
• Identify additional revenue maximization opportunities for IDHS
• Develop reports and present data to the State
• Utilize influence to eliminate bottlenecks and potential resource alignment problems
• Work remotely

An ideal candidate has the following:

• U.S. Citizenship
• Bachelor's degree
• 7 years of experience with Medicare and Medicaid revenue maximization services
• Expert in automation in healthcare claims and holds a coding certification
• Proficient in Financial Analysis, Project Management, and Business Analysis practices, principles, and tools
• Excellent written and verbal communication skills

Join the team at Barrow Wise Consulting, LLC for a fulfilling and engaging experience! Our team is dedicated to providing innovative solutions