Manager, Revenue Cycle Management

Nox Health•Alpharetta, GA

About The Position

Reporting to the Director of Revenue Cycle Management, the Manager, Revenue Cycle Management collaborates cross-functionally on all revenue, billing, and insurance-related activities. This role oversees all billing operations and revenue recognition processes, manages insurance billing and collections, and leads the implementation of new insurance partners. The Revenue Cycle Manager is responsible for maintaining all databases and financial models within the Revenue Cycle Department and ensuring full compliance with the Company’s revenue recognition policies.

Requirements

High School Diploma required; college degree preferred.
5+ years’ experience as a revenue cycle leader: managing verification of benefits, authorizations processes, working with medical policies, customer service, billing, and collections in a healthcare setting.
Prior revenue cycle leadership experience managing at least 5-7 team members.
Intermediate Doc/Word and Sheet/Excel skills – prefer experience managing data sets and dashboards.
Previous experience with cash posting and reconciliation to bank deposits.
Understanding and experience working with health plans to set up claims processing.
Managing invoice-based billing or hybrid billing.
Experience working with multiple claim processing sites/avenues including Availity, Office Ally, Change Healthcare, as well as direct health plan sites.
Experience with client facing roles preferred.

Responsibilities

Responsible for all activities of the accounts receivable department to ensure the accurate and timely management of all accounts receivable aging components including billings, cash receipts application, etc.
Responsible for all aspects of Revenue Recognition in compliance with Company policies.
Oversee and manage all aspects of insurance and patient billing and collection to ensure accurate, timely, and complete insurance estimates, billing, collections, reconciliations of patient records and subledgers in accordance with business rules.
Manage the implementation of new insurance integrations to ensure a smooth implementation across all departments in accordance with business rules. Develop and maintain insurance fee schedules.
Manage relationships with all insurers to ensure timely and smooth handling of all claim related matters.
Responsible for the active patient database to ensure all necessary billing and termination activities are handled appropriately and timely in accordance with business rules.
Oversee the annual renewal process ensuring patient eligibility requirements are timely and properly enforced.
Oversee the individual self-pay program process for member enrollment.
Develop and maintain key metrics related to participant engagement, billing, revenue, participant renewals and terminations.
Establish documentation, processes, and procedures.
Work with other departments to achieve process improvements and streamline the billing and collection processes with a focus on improving the patient experience.
Provide training and coaching companywide for all insurance, billing, and collection related matters.
Participate in a wide variety of special projects and compile a variety of special reports.
Other duties as assigned.