Supervisor, Revenue Cycle Management, Billing

What Revenue Cycle Management (RCM) contributes to Cardinal Health

Practice Operations Management oversees the business and administrative operations of a medical practice.

The Revenue Cycle Management team focuses on a series of clinical and administrative processes that healthcare providers utilize to capture, bill, and collect patient service revenue. The revenue cycle shadows the entire patient care journey and begins with patient appointment scheduling and ends when the patient’s account balance is zero. Directly supporting cCare, the largest private oncology practice in California, our experienced revenue cycle management specialists simplify and optimize the practice’s revenue cycle, from prior authorization through billing and collections.

The Revenue Cycle Supervisor is responsible for generating revenue by monitoring and pursuing payment for all unpaid and delinquent denied claims. They also act as a liaison between the provider, payors, and patients for charge submission and maintain daily and monthly productivity goals to maximize cash flow.

Essential Functions:

• Review and identify opportunities for improvement on Power BI.
• Provide executives, manager, and center support with denial trends and presentations.
• Research denied CPT codes and compare them to the LCD/NCD requirements.
• Identify trends that inhibit timely claim submission for all centers.
• Work closely with insurance carriers for reimbursement requirements to ensure payment.
• Understand electronic claim interchange and the life cycle of primary and secondary claims.
• Contribute to team efforts by accomplishing related results as needed.
• Ensure that all processing and reporting deadlines are consistently achieved.
• Oversee staff and processes concerning third-party insurance and data processing to ensure accurate billing and efficient account collection.
• Occasionally, review patient account status to identify and resolve billing and processing problems promptly.
• Maintain contact with other site managers/centers to obtain and analyze additional patient information to document and process billings accurately.
• Work closely with the billing staff to develop and oversee business systems. Also, work with other key areas to ensure timely and accurate processing and system reporting.
• Collect and process payroll for billing staff.
• Maintain billing staff PTO requests and ensure proper staffing and department coverage.
• Identify accounts receivable opportunities and propose processes for clean claim submission.
• Ensure a successful (EOM) close and movement of charges.
• Stay up to date on payer requirements and provide staff with further training.
• Handle other duties and projects assigned.

Qualifications

• 4-8 years of experience, preferred
• Bachelor's degree in related field, or equivalent work experience, preferred

• Knowledge of medical terminology
• Familiar with Urology, Chemotherapy and Radiation Billing

• Experience with computerized billing software and interpreting EOBs
• Working knowledge of ICD-9/ICD-10, CPT, HCPCS, and CPT coding
• Bachelor's degree, preferred in business administration, healthcare, or related field.
• Minimum five years of experience in a medical business office. 
• Preferred experience with GE Centricity.  Preferred experience in Oncology billing.
• Knowledge of computer/telephony support, preferably in a healthcare environment
• Strong customer service background, preferably in a healthcare environment
• Excellent verbal communication skills
• Competence with computer processing functions and other standard office equipment
• Ability to manage and prioritize multiple tasks
• Ability to calmly and professionally resolve customer issues with diplomacy and tact
• Ability to work independently with minimal supervision
• Strong organizational skills
• Understanding of managed care contracts and fee schedules, including Medicare and Medicaid

Anticipated salary range: $74,400 – $95,670USD Annual

Bonus eligible: No

Benefits: Cardinal Health offers a wide variety of benefits and programs to support health and well-being.

• Medical, dental and vision coverage
• Paid time off plan
• Health savings account (HSA)
• 401k savings plan
• Access to wages before pay day with myFlexPay
• Flexible spending accounts (FS