Manager A/R - Ambulatory Surgery Center (ASC)

Carolina Neurosurgy & Spine Associates•Charlotte, NC

6d•Onsite

About The Position

This AR Manager – ASC owns the accounts receivable function for ambulatory surgery center (ASC) business, ensuring timely, accurate, and compliant collection of facility-side claims. This role is distinct from professional/physician billing AR: ASC reimbursement is driven by facility fee schedules, case-rate and bundled payer contracts, implant and device cost recovery, multiple-procedure payment reductions, and ASC-specific authorization and medical necessity requirements. The AR Manager – ASC is accountable for AR aging, net collection rate, and denial resolution specific to the facility claim stream, and works in close coordination with the ASC business office, coding, and managed care contracting to ensure facility reimbursement reflects the true cost and complexity of cases performed. This role requires direct, demonstrated ASC revenue cycle experience – general physician billing AR background alone is not sufficient given the structural differences in how ASC claims are built, priced, and adjudicate.

Requirements

2-5+ years of progressive billing management experience for a medical group, surgical specialty, or health system
3 years of Ambulatory Surgery Center billing and collections experience
Strong working knowledge of ASC fee schedules, CMS ASC payment groupings, case-rate/bundled payer contracts, and multiple-procedure payment reduction rules
Experience managing implant and device cost recovery and carve-out billing
Deep expertise in billing, coding, reimbursement, and payer dynamics
Demonstrated ability to design and implement scalable processes that improve efficiency and support growth
Proven success leading and developing multi-site teams, with a focus on engagement, performance, and retention
Experience with practice management/EHR systems supporting ASC billing workflows (e.g., Epic)
Strong analytical skills with experience using data to inform strategy and decision-making
Experience implementing process improvements, systems, or automation within the revenue cycle
Bachelor’s degree in a relevant field, or equivalent combination of education and experience

Nice To Haves

ASC billing/coding certification (e.g., CASCC) or equivalent specialty credential
Experience in a multi-specialty surgical ASC supporting neurosurgery, orthopedics, spine, or pain management procedures
Experience negotiating or supporting managed care contract language related to ASC reimbursement
Familiarity with NSA/IDR (No Surprises Act/Independent Dispute Resolution) processes as applied to out-of-network ASC claims
Experience operating within a multi-entity or MSO ASC structure

Responsibilities

Own AR performance for the ASC facility claim stream — aging, net collection rate, cash application accuracy, and timely follow-up across all payer classes
Lead denial management specific to ASC claims, including medical necessity denials, multiple-procedure payment reductions, implant/device-related denials, and bundling/unbundling disputes
Manage and develop AR staff dedicated to ASC accounts, including productivity standards, quality audits, and coaching
Partner with managed care contracting to ensure case-rate, per-diem, and bundled payment terms are being correctly applied and reimbursed
Oversee implant and high-cost device billing and cost recovery, ensuring documentation and carve-out billing requirements are met per payer contract
Validate facility fee schedule application and identify underpayment patterns relative to contracted rates
Collaborate with the ASC business office (e.g., CCSS) on prior-authorization accuracy, case scheduling documentation, and charge capture completeness ahead of claim submission
Identify and escalate systemic issues in ASC claim build, coding-to-billing handoff, or payer adjudication, and partner with Process Improvement on SOP development
Monitor and report ASC-specific KPIs (days in AR, clean claim rate, denial rate by category, implant cost recovery rate) to RCM leadership
Stay current on ASC-specific payer policy changes, CMS ASC payment system updates, and state ASC licensure/billing requirements
Serve as the AR escalation point for high-dollar or complex ASC claims requiring payer appeal or peer-to-peer-adjacent resolution