MD EyeCare Services Corporate

  • RBO, Revenue Cycle Manager

    Job Locations US-CO-Denver
    Posted Date 1 month ago(9/21/2018 11:08 AM)
    Job ID
    2018-2751
    # of Openings
    1
    Category
    EyeCare Services Partners
    Type
    Regular Full-Time
  • Overview

     

     ESP Logo

     

    Eyecare Services Partners is a nationally recognized leader in Ophthalmic and Optometric care with dynamic leadership, excellent clinical support teams and an unwavering commitment to customer service and patient care.  We strive to make every interaction extraordinary, inspiring the complete confidence of our patients, partners and employees.  Our employees contribute directly to the success of our practices and take pride in being a member the ESP Management team. We strongly believe that the manner in which our patients, customers and employees is as important as the quality of the services we provide.

     

    The Regional Business Office (RBO) Revenue Cycle Manager reports to the Director of Revenue Cycle. They will oversee the day to day operations of the Regional Business office for EyeCare Services Partners Management LLC (ESP). The manager will be responsible for the processing of claims through the practice management system, the reconciliation of claims to the clearing house and the follow-up of denials.

     

    The manager will support and assist in change management thorough the organization as business needs and industry standards require change to ensure corporate and regulatory standards are met.

     

    This position requires a highly motivated, productive and experienced billing professional with a desire to work in a dynamic and fast-paced organization.  As ESP expands, the RBO Manager will assist in the growth of their assigned office.

    Responsibilities

    • Directly manage and oversee the staffing, training, support and development of the Regional Business Office.
    • Support and maintain standardized billing department policies and procedures and ensure clinical operations (i.e. OD’s, MD’s and DO’s) comply with SOP’s that ensure maximum collections and regulatory compliance, acting as a liaison among accounting, billing, operations and clinical staff.
    • Perform analytical reviews and quality assurance on all data generated by Billing and Collection Department to ensure data integrity.
    • Work closely with operations team to assure communication of information necessary to ensure efficient processes are understood and implemented in accordance with policies and procedures.
    • Provide denial reports to operations and assist in helping resolve the root cause of denials.
    • Ensure proper billing and collections relating to commercial and government reimbursement.
    • Responsibility for regulatory compliance and credentialing as it relates to payer transactions as well as HIPAA and PHI regulations.
    • Responsible for accurate and timely billing, data entry, charge corrections, adjustments and Denial management.
    • Manages the EDI functions as they relate to electronic claims submission, denial management, and related systems for scope of business.
    • Ensure billing software is updated with current versions; perform appropriate testing and implementation. Ensure enterprise level databases are kept current.
    • Provides reimbursement direction and resources for start-up and newly acquired locations to ensure a smooth transition and uninterrupted cash flow.
    • Third party claim resolution processes including denials and appeals management.
    • Generate and distribute billing metrics for dissemination to the facility staff, Operations Team and Corporate Services Team.
    • Considers company budget goals in assessing expenditures for reimbursement management; fiscally prudent.
    • Review and approve adjustments to receivables.
    • Review reimbursement levels to determine when changes take place and keep abreast of changes in the industry that will impact charging patterns and reimbursement levels.
    • Follows Red Flag Policy and Procedures.
    • Ensure complete patient confidentiality as established by practice policies and HIPAA.

    Qualifications

    • Bachelor’s degree in Business Administration, Accounting, Finance or commensurate experience in healthcare industry. 
    • Must have 5-8 years of progressive work experience in revenue cycle, patient accounts, managed care and/or financial analysis in the healthcare industry.
    • 2-3 years of management experience.
    • Strong communication skills. Ability to communicate with senior management and hourly associates that report to Manager.
    • Thorough knowledge of Microsoft Excel and other billing system platforms is necessary.
    • Understanding of medical coding systems. These include ICD-10, CPT, HCPCS, APG, APC, and revenue code structures.
    • Financial analysis skills including strong analytical capability.
    • Knowledge of industry reimbursement methodologies.
    • Must have the ability to identify root cause and problem solve, adaptable communication skills, organizational/multi-tasking skills, prioritization, etc.
    • Must take and successfully pass the AAO Coding Specialist and Retina Specialist Certifications.

      In turn we will offer:

    • Benefits to full time team members that include comprehensive medical, dental and optical coverage, 401K and short term disability
    • Company paid life insurance
    • Paid holidays and generous paid time off
    • Paid parking where applicable
    • Team oriented working environment where you are heard and respected
    • Clear career ladder opportunities

    To learn more about us, please visit:  www.espmgmt.com 

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