Experienced Revenue Cycle Manager - Home Infusion

Ais Healthcare • Denver, CO

226d • Remote

About The Position

This is a 100% remote position -please apply only if you have 3-5 years of Medical Insurance Revenue Cycle Management experience. AIS Healthcare is the leading provider of Targeted Drug Delivery (TDD), and Infusion Care. With our diverse culture, and our values around Innovation, Stewardship, and Unity, we are committed to Advancing Quality, and Improving Lives. We are dedicated to doing more for our patients by providing quality products and services that enhance the entire care experience. AIS Healthcare is looking for an experienced and motivated Accounts Receivable Collections Manager to join our dynamic team! This position is responsible for directing and coordinating the day-to-day activities of the Miscellaneous Accounts Receivables Teams (including Aetna, Cigna, Commercial, Medicare, and Medicaid payers) in an effort to maximize reimbursements from various payors. The Manager oversees these groups, whose primary responsibilities include; managing denials, preparing appeals, and ensuring reimbursements are aligned with the AIS' contracted payors. The Collections Manager will routinely perform quality reviews, determine training needs, and assist in the documentation of policies and procedures.

Requirements

• A high school diploma or general education degree (GED) equivalent is required; bachelor's degree preferred.
• 5-7 years of healthcare industry experience required.
• Home Infusion, Intrathecal Pain Management experience preferred.
• 3-5 years Revenue Cycle Management experience required.
• Understanding of all Revenue Cycle Management functions and integration of one another.
• Ability to recognize, evaluate and exercise good judgment in solving complex situations and advising in accordance with laws and regulations.
• Excellent verbal and written communication and relationship building skills with an ability to prioritize, negotiate, and work with a variety of internal and external stakeholders.
• Strong work ethic with personal qualities of integrity and credibility.
• Ability to deal with highly sensitive and confidential material, strong knowledge of HIPAA privacy guidelines and requirements.
• Competence with ICD-9 and ICD-10.
• Knowledge of medical terminology.
• Ability to lead and direct a diverse department in an environment with frequent changes and priorities.
• Ability to communicate effectively and professionally with patients, visitors, physicians, and coworkers.
• Self-directed, detail oriented, conscientious, organized, and able to follow through.
• Ability to supervise and train employees, to include organizing, prioritizing, and scheduling work assignments to meet timelines.
• Ability to deal in an organized manner with problems involving multiple variables within the scope of the position.
• Ability to make independent decisions when circumstances warrant; make prompt and accurate judgments regarding collection operations.
• Skill in establishing and maintaining effective working relationships with other employees, patients, organizations, and the public.
• Tolerant of frequent interruptions and distractions from staff and other internal support teams.
• Proficient in Microsoft Office, including Outlook, Word, and Excel.

Nice To Haves

• Home Infusion, Intrathecal Pain Management experience preferred.

Responsibilities

• Oversees the operations of the collections department, encompassing contract analysis, accounts receivables, denials, claims monitoring, adjustments, appeals and staff productivity and quality.
• Serves as the Subject Matter Expert (SME) for all collection and billing processes.
• Maintains contact with other departments to obtain patient or insurance information needed for claims payment.
• Prepares, analyzes, and distributes bi-weekly progress reporting.
• Prepares, analyzes, and distributes monthly and/or quarterly score cards of department.
• Prepares other billing and financial reports as assigned.
• Responsible for understanding all procedures within regulatory mandates.
• Performs quality reviews on current procedures to monitor and improve efficiency of collection and billing operations.
• Ensures that the activities of the collection operations are conducted in a manner that is consistent with overall department protocol, and are following Federal, State, and payer regulation, guidelines, and requirements.
• Participates in the development and implementation of operating policies and procedures.
• Analyzes trends impacting charges and coding and takes appropriate action to realign staff and revise policies and procedures.
• Supervises collection staff, which includes work allocation, training, and being available for staff needs; motivates employees to achieve peak productivity and performance both in an in-office and remote setting.
• Coordinates staff time off in a manner that does not negatively impact necessary daily functions.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
• Maintains a thorough understanding of NDC (National Drug Code) numbers, metric quantities, and knowledge of infusion supplies.
• Maintains a broad range of knowledge of insurance plans, medical terminology, billing procedures, government regulations, and medical codes.
• Shares knowledge gained with other staff members and works as a team member.
• Interacts with others in a positive, respectful, and considerate manner.
• Completes hiring, scheduling of staff, time, and attendance review.
• Conducts frequent 1:1's with staff, team meetings, performance management and reviews, including disciplinary action, as necessary.
• Performs other job related duties as assigned.

Benefits

• Health insurance
• Vision insurance
• Dental insurance
• Long term disability insurance
• Life insurance
• Yearly bonus opportunity
• Vacation package
• 401K plan with a generous employer match
• Hybrid office/work from home opportunity
• Growth opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Ambulatory Health Care Services
• Education Level: Bachelor's degree