Revenue Cycle Manager

4 weeks ago

Karachi, Sindh, Pakistan Infina Health Full time
We are an emergency (EMS) and non-emergency (NEMT) medical transportation company looking for an experienced revenue cycle manager.

Responsibilities include invoice generation and review, submission, tracking, and follow-up; and on the EMT side: conducting eligibility checks, 1500 form generation, e-submission of claims using our billing platform Ability by Inovalon, and appeals.

The revenue cycle manager's responsibilities include identifying patient reimbursement issues, ensuring that claims, denials, and appeals are efficiently processed, and resolving billing-related issues. You should also be able to code diagnoses and procedures correctly. Familiarity with navigating insurances, and Medicare/Medicaid managed care plans is a must.

To be successful as a revenue cycle manager, you should be able to manage both sides of the business. For our NEMT business, we utilize a logistics platform to generate invoices for our payers, a handful of which are currently managed through a manual, Excel-based process. The EMS side of the business is more sophisticated, utilizing an online billing platform.

Ultimately, a top-performing revenue cycle manager should seek ways to improve the functioning of the revenue cycle department without interrupting ongoing collection efforts. Currently, management is heavily involved in collection efforts and would like to delegate control to a forward-thinking and entrepreneurial individual who will meet collection goals and thrive in a challenging but motivating environment.

Revenue Cycle Manager Responsibilities:
  • Implementing a system to ensure that accurate billing information is entered into the billing system. We welcome you to optimize or create an ideal revenue cycle environment. The company is willing to invest in the right vision.
  • Able to function between two worlds: a manual Excel-based process and an automated online billing platform.
  • Supervising the revenue cycle department in duties such as account management, communications with insurance providers, collections, cash posting, and billing.
  • Managing staff performance by providing regular feedback, performance reviews, and one-on-one meetings. The department currently includes two part-time staff, but the future structure is flexible.
  • Overseeing hiring and training of staff.
  • Crafting strategies for revenue cycle management and business growth, including analyzing denial rates and adjusting rates accordingly, revenue analysis, and business analysis.
  • Acting as a critical leader, helping shape the company's direction and growth through fact-based recommendations and thoughtful discussion.
Revenue Cycle Manager Requirements:
  • Experienced revenue cycle professional with professional billing experience.
  • Experience with transportation billing, similar to primary care billing, with a small set of codes.
  • The main challenge lies in tracking and follow-up across different lines of business, not billing itself.
  • Proficient in Microsoft Office applications and medical office software.
  • Strong skills in Microsoft Excel.
  • Proven experience in healthcare billing.
  • Knowledge of health insurance providers.
  • Strong interpersonal and organizational skills.
  • Excellent customer service skills.
  • Ability to work in a fast-paced environment.
  • An innovative mindset, thinking out of the box.
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