Billing and Collections Regional Manager - Remote

Blue Cloud Pediatric Surgery Centers • Phoenix, AZ

51d • $70,000 - $80,000 • Remote

About The Position

At Blue Cloud, it's our vision to be the leader in safety and quality for pediatric dental patients treated in a surgery center environment. Our core values drive the decisions of our talented team every day and serve as a guiding direction toward that vision. 1. We cheerfully work hard 2. We are individually empathetic 3. We keep our commitments The CBO Regional Manager, Billing and Collections Operations is a revenue cycle management (RCM) leadership position responsible for the day-to-day management of the billing and accounts receivable (A/R) processes for a defined Blue Clue region of facilities. This role focuses on maximizing revenue and payment capture by ensuring accurate, timely claim submission, aggressive payer follow-up for payor and patient payment issues, and effective denial management to identify and mitigate denial root causes. The Regional Manager will lead and grow a comprehensive billing and collections team, implement best practices, and work closely with the other region-based teams, vendors, facility operators and internal stake holders to optimize RCM performance.

Requirements

• Bachelor's degree in Business Administration, Healthcare Administration, Finance, or a related field (Master's preferred).
• Minimum of 5 years of experience in healthcare billing and collections, with at least 2 years in a supervisory or management role, preferably within a surgical or ASC environment.
• Strong knowledge of ASC coding, billing and reimbursement methodologies.
• Proficiency in Microsoft Excel, Power BI, and data analysis tools and demonstrated ability to develop executive-facing work products that outline performance, risk, and opportunities to optimize revenue and payment capture.
• Excellent problem-solving, leadership, and communication skills.
• Ability to manage multiple priorities in a fast-paced environment.
• Must maintain strict confidentiality in accordance with HIPAA and company policies.
• Ensure all revenue cycle activities align with federal and state compliance regulations

Nice To Haves

• Dental/Oral Surgery experience is a significant plus.
• HFMA's Certified Revenue Cycle Representative (CRCR), Certified Professional Biller (CPB), or Certified Professional Coder (CPC) preferred.
• Demonstrated expertise in dental and multi-specialty is preferred.
• Demonstrated utilization and optimization of workflows, functionality and reporting in EMR and PAS solutions (e.g., Epic, Cerner, Allscripts, HST Pathways, SIS Complete).
• Experience using Open Dental is a plus. Additionally, experience utilizing and optimizing clearinghouse solutions (e.g., Availity) is preferred.

Responsibilities

• Manage billing and collection strategies, policies, and procedures to achieve best-in-class RCM performance (e.g., cash to net revenue, DNFB, A/R days, clean claim rate, denial rate, etc.).
• Manage the day-to-day operations of a region-based billing and collections team, ensuring daily operations are efficient, compliant, and meeting performance targets.
• Work closely with internal payer relations and insurance payer representatives to ensure proper contracted rates are captured and billed appropriately by responsible RCM teams.
• Ensure Blue Cloud is capturing revenue and billing in adherence to federal, state, and payer-specific regulations and lead internal audits to maintain compliance. Adheres to and reinforces coding, billing, collections and payment posting internal controls and auditing protocols to optimize net revenue capture and reimbursement in a compliant manner.
• Manage and provide recurring quantified detail for key revenue cycle performance and staff productivity metrics, key performance indicators, and productivity standards and create data visualization and reporting to highlight opportunities, variance and risk and optimize team performance.
• Identify areas for improvement and implement solutions for revenue cycle operations functions and payment variance workflows, reporting, and data visualization, and implement best practices to improve efficiency and performance and scale to support continued platform and volume growth.
• Recruit, train, mentor, and manage a multi-disciplinary, multi-specialty team to perform and oversee billing and collections processes for all Blue Cloud facilities. Provide continuing education and professional development to maximize retention and career progression of team members and leaders.
• Aid executive leadership and development teams with revenue modeling, sensitivity analysis, and forecasting to optimize growth strategy, pro forma accuracy, and ROI for all de novo and M&A activity

Benefits

• Work with a passionate, dedicated, and talented team in a growing organization committed to doing good
• Health insurance, Flexible Spending and Health Savings Accounts, disability coverage and additional voluntary plans
• 401k plan, including company match
• Paid Time Off
• No on call, no holidays, no weekends

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Industry: Hospitals
• Number of Employees: 501-1,000 employees