Revenue Cycle Supervisor
About The Position
Empowering Wellness, Transforming Lives Optima Medical Management Group is dedicated to enhancing the quality of life by promoting wellness. At Optima MMG and all of its divisions: Serene Health, Community Support, and American TrueCare, our mission is to provide comprehensive support and care that not only addresses immediate concerns but also fosters long-term well-being. As pioneers in the field, we aspire to lead in member care outcomes and set new standards for excellence and innovation. We are committed to empowering our members to achieve self-sufficiency in health, creating a ripple effect that strengthens families and communities. Our work culture at Optima MMG is built on pride, passion, and a collective commitment to making a positive difference in people's lives. Our team members are dedicated problem-solvers who bring their unique skills and perspectives to the table. We believe that by fostering a collaborative and supportive environment, we can unlock the full potential of our team and, in turn, provide the best possible care to our members. A career at Optima MMG is an opportunity to be part of a dynamic and forward-thinking organization. We encourage continuous learning and professional growth, providing our employees with access to industry experts, cutting-edge technologies, and a supportive community that values each individual's contributions. Join us on this journey to not only advance your career but to be a driving force in transforming lives and communities through passionate and fulfilling work!
Requirements
- Bachelor’s degree in Business Administration, Healthcare Administration, or a related field required.
- Demonstrated knowledge of medical billing, coding, claims, collections processes and strategy, reimbursement methodologies, and payer processes required.
- Advanced analytical skills with the ability to interpret financial and operational data required.
- Excellent communication, leadership, and problem-solving skills required.
Nice To Haves
- Prior supervisory experience highly preferred.
- Three (3) years of current experience for revenue cycle management environment preferred.
- Professional certifications such as CRCR, CPC, CPB, or related Epic certifications in revenue cycle preferred.
- Experience Medi-Cal and Managed Care billing preferred.
- Experience with capitated payment models and fee-for-service billing preferred.
Responsibilities
- Lead revenue cycle staff to achieve operational and performance goals.
- Establish clear performance expectations and conduct regular evaluations.
- Foster collaboration across departments including accounting and procurement.
- Oversee daily execution of the billing, accounts receivable, denials management, patient collections and release of information.
- Ensure clean claim submission, timely follow-up, and optimal cash flow performance.
- Monitor workflow effectiveness and identify opportunities to streamline processes and reduce revenue leakage.
- Act as primary escalation point for daily revenue cycle operations support.
- Collaborate with front-end teams to improve operations and reduce preventable denials.
- Ensure coding processes are followed to ensure accuracy, completeness, and compliance with regulatory and payer requirements.
- Manage claim submission processes, edits, and work queues to maximize first-pass yield.
- Analyze denial trends, identify root causes, and implement corrective action plans.
- Monitor payer reimbursement accuracy against contract terms and fee schedules.
- Support payer contract modeling, variance analysis, and underpayment appeals.
- Partner with contracting and finance teams to improve net revenue performance.
- Optimize processes and standard operating procedures to support best practices and standardization.
- Perform other duties as assigned.
Benefits
- Medical, Dental, & Vision Benefits
- Short & Long-Term Disability Benefits
- Voluntary Accident, Voluntary Critical Illness, and Voluntary Hospital Indemnity Plans
- Flexible Spending Accounts
- Employee Assistance Program (EAP)
- 401(K)
- Paid Vacation and Sick Leave
- Paid Holidays
- Employee Referral Program
- Company Discount Program
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
