Senior Manager, RCM

Fulgent Genetics, Inc.•Coppell, TX

29d

About The Position

The Senior Manager, Revenue Cycle Management is responsible for managing performance and policies administration for coding, data entry, billing, accounts receivable (AR), and reimbursement activities for their team. This includes securing, maintaining, and distributing the most current coding and payer information and implementing changes in a manner that supports timely, accurate and compliant filing and reimbursement. This role will also focus on fostering collaboration between RCM vendors, sales, and clinical departments to improve efficiency and patient experience.

Requirements

Bachelor's degree in business administration, healthcare or related field or equivalent experience.
Ten years billing experience in a healthcare environment and 7 years of progressive leadership experience.
Knowledge of Revenue Cycle Management functions, including, but limited to Data Entry, ICD-10 Coding, Accounts Receivable Management, and Remittance Application.
Proficient in Microsoft Office Suite, specifically Word, Excel, and Outlook, and general working knowledge of Internet for business use.
Ability to work in a fast-paced, deadline driven environment.
Drive for Results (Service, Quality, and Continuous Improvement) Ensure procedures and processes are in place that lead to delivery of quality results and continually reassess their effectiveness to achieve continuous improvement.
Proficient verbal and written communication skills. Willingness to share and receive information and ideas from all levels of the organization in order to achieve the desired results.
Commitment to the successful achievement of team and organizational goals through a desire to participate with and help other members of the team.
Customer Service Focus Demonstrate a focus on listening to and understanding client/customer needs and then delighting the client/customer by exceeding service and quality expectations.

Nice To Haves

Knowledge of medical Anatomical Pathology is a plus.

Responsibilities

Build and oversee the full RCM Integrity program, from patient services to claims submission and collections, ensuring compliance with Payor & ASCP requirements.
Conduct standard RCM risk assessments and audits across inhouse & offshore practices to identify potential areas of vulnerability and implement corrective action plans as needed.
Advise senior leadership on matters involving billing integrity, regulatory compliance, and financial risk management.
Recommend process improvements and implement approved changes to enhance operational performance.
Serves as the primary liaison for escalated RCM issues, partnering with clinicians, sales, third-party billing vendors and billing staff.
Develop, document, and implement approved revenue cycle policies, procedures, and workflows that align with federal and state regulations, payer contracts and reporting requirements.
Acts as administrator for payor portals & EDI connectivity with Third Party Payors.
Remain current with changes in reimbursement regulations.
Collaborates with management on operational performance and changes needed in the operation.
Notifies and trains staff on significant coding and billing changes.
Gather and review reimbursement data, analyzes results, prepares report and oversee the resolution of any identified issues.
Train clinicians, sales, and billing department staff.
Assist with the selection, training, and performance evaluation of supervisors and staff.
Plan, direct, and supervise coding, data entry, billing, and collections supervisors and staff to ensure timely, accurate, and complete processing of services while ensuring all quality and production goals are met.
Resolve employee relations issues and recommends disciplinary action when required.
Focus on improving all KPI metrics.