Manager, Zero Balance

Aspirion • Alameda, CA

5h • $60,000

About The Position

For over two decades, Aspirion has delivered market-leading revenue cycle services. We specialize in collecting challenging payments from third-party payers, focusing on complex denials, aged accounts receivables, motor vehicle accident, workers’ compensation, Veterans Affairs, and out-of-state Medicaid. At the core of our success is our highly valued team of over 1,400 teammates as reflected in one of our core guiding principles, “Our teammates are the foundation of our success.” United by a shared commitment to client excellence, we focus on achieving outstanding outcomes for our clients, aiming to consistently provide the highest revenue yield in the shortest possible time. We are committed to creating a results-oriented work environment that is both challenging and rewarding, fostering flexibility, and encouraging personal and professional growth. Joining Aspirion means becoming a part of an industry leading team, where you will have the opportunity to engage with innovative technology, collaborate with a diverse and talented team, and contribute to the success of our hospital and health system partners. Aspirion maintains a strong partnership with Linden Capital Partners, serving as our trusted private equity sponsor. We're seeking an experienced revenue cycle expert to manage multiple ongoing client engagements, manage staff, prepare and present detailed reports, analyze revenue opportunities, interpret contract terms, and anticipate legislative changes affecting reimbursement. In addition, we would ask you to provide our clients with claims data showing payer performance and root-cause analysis of underpayment issues, which can be leveraged when negotiating with payers and assessing the overall business performance. Ideal candidates will have extensive underpayment knowledge, prior supervisory experience, and advanced presentation skills.

Requirements

• Thorough understanding of reimbursement methodologies (Health Insurance contracts, Medicare, and Medicaid)
• Excellent written and verbal communication skills
• Knowledge of government compliance rules and issues as it pertains to healthcare billing and reimbursement
• Comfort with large data sets, manipulating data in SQL, MS Access and comparable database platforms
• Proven leader, experience managing teams; ability to motivate and mentor junior staff
• Self-directed and organized with analytical and problem-solving skills
• Comfortable presenting to both internal and externa stakeholders, including C-suite level members
• Ability to develop logic to price claims under various reimbursement methodologies including coordination of benefits, third party liability, Diagnosis Related Groups (DRGs), Case Rates, Ambulatory Payment Classification (APC), Outpatient Fee Schedules, Division of Financial Responsibility (DoFR) and Capitation
• Knowledge of the charge capture processes; prior experience conducting charge capture audits is a plus
• Balance and maintain day-to-day operational duties while also performing providing leadership responsibilities
• Company wide engagement and leadership
• Bachelor’s degree in healthcare management, Business, Finance or Accounting or an equivalent combination of education and experience
• Minimum 5 years healthcare experience; patient account services, revenue cycle operations or payer contracting
• Experience with Zero Balance claims preferred
• Prior supervisory experience preferred

Responsibilities

• Analysis of hospital contracts to identify potential underpayment opportunities
• Translation of contract terms into mathematical formulas to identify underpaid claims
• Identify opportunities for process improvements for both client and internal processes
• Manage day-to-day work of 15-20 direct reports
• Train staff in the areas of underpayment identification, healthcare industry processes and standards, communicating and negotiating with insurance companies
• Escalate and resolve payment disputes with payer and serve as a liaison between client and payer
• Establish metrics to monitor staff performance; prepare and deliver performance evaluations and resolve any staff related issues
• Provide Subject Matter Expertise support with clients and staff

Benefits

• At Aspirion we invest in our employees by offering a full benefits package, including health, dental, vision and life insurance upon hire, matching 401k, competitive salaries, advancement opportunities, and incentive programs.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager