RCM Account Manager

Aprima Careers•Richardson, TX

About The Position

Responsible for the management of all aspects of billing operations to include, but not limited to; billing, collections, reimbursement, charge entry and customer service for designated clients. Must be experienced in all facets of the billing process including but not limited to; charge entry, claim edits, electronic transmittal, electronic receipts, billing and accounts receivable report analysis, claim processing, insurance verification, cash reconciliations, collections from insurance companies as well as patients.

Requirements

High school diploma/GED
Minimum of three years’ experience managing employees in a AR healthcare environment
Minimum of two years’ experience in physician professional billing (Managed Care, Commercial and or CMS Part B claims adjudication
Must be detail-oriented and organized
A self – starter capable of tracking to deadlines and meeting goals with little supervision required
A high level of analytical and problem solving skills is expected
Must be able to display outstanding leadership skills
Must work autonomously with little or no supervision
Must demonstrate very good communication, customer service, and organizational skills
Very good verbal and written communications is desirable
Ability to conduct department presentations
Is expected to apply appropriate reasoning to their decision regarding their approach to managing the AR of their assigned work
Is expected to communicate persuasively, both orally and in writing.
Must possess general office skills and computer knowledge
Strong working knowledge of the Next Gen EPM practice management system and or GE Centricity Business system and coordinating modules, is preferred
MS Excel Spreadsheet software, MS Word Processing software and MS Power Point software.

Nice To Haves

Bachelor’s degree in a business-related field is strongly desired.

Responsibilities

Responsible for the daily management of staff and the day-to-day operations related to billing.
Monitor daily production department goals by setting clear expectations and holding staff accountable to those expectations
Develop new employees and existing employee training, provide on-going formal feedback to all staff members, and clearly outline performance expectations.
Continuously develop and foster a supportive work environment.
Organize staff to adequately perform daily functions.
Responsible for developing specific and measurable metrics to monitor staff and client performance which include developing reports and action plans.
Ensure all staff are trained to operate the billing system.
Ensure all staff are educated on applicable payer specific guidelines and utilize consistent billing policies.
Identify staff within practices who require additional training.
Consistently analyze billing operations by reviewing daily, weekly and monthly system reports to identify trends in A/R and payor mix
Develop, implement and manage policies and procedures for daily billing activities and best practices in regards to billing
Continually assess staffing needs based on client's projected budget
Directly responsible for ensuring positive customer relations with the client
Communicate with physicians, payers, patients, and administrative staff within practices as required
Perform other duties as assigned to maintain departmental functions
Provide strategic insight and recommendations on maximizing cash collections to AR Manager/Director
Identify and resolve insurance claim denials
Keeping abreast of payer/carrier rules and regulations (Self-pay HMO/PPO and Gov’t payers)
Keeping upper management abreast of both successes and problems as they occur.
Maintenance of adequate staffing levels
Counseling sessions and disciplinary write-ups
Participate in various committees as required
Participate in problem resolution at all levels
Be a role model within the department by exhibiting mature leadership qualities such as a positive outlook, confidentiality, respect, and team spirit.
Attend meetings as required
Assure that HIPAA compliance guidelines are followed
Ability to cover and perform all duties in the absence of employees.
Other duties as assigned by Sr. Account Manager/Director/VP RCM.