Revenue Cycle Billing Manager
Matter Health, United States
Job Description
Matter Health exists to bring primary care health services directly to older adults. We built on-site clinics in affordable housing developments that offer a personalized, holistic and high-touch approach to the patient/provider relationship. We are revolutionizing the way that healthcare is delivered to those that need it most.
With a successful Series-A raise and an ambitious expansion plan, the business is searching for talented people with experience to be a part of our evolution to delivering world class Value Based Care. Changing healthcare requires more than just great skills, it requires the ability to live the values of Matter Health every day.
We have a lot of positive change to make in the world and to make this change we will need mission oriented, collaborative teammates. Matter is a company that promotes speaking up and offering ideas that make us better. We hire the best people and give them autonomy, support and resources they need to be successful. There is accountability and responsibility for the work you will do but there is a team beside you always ready to support. Every voice matters and all voices will be heard. Are you ready to shake up healthcare for older adults? Join us on our journey!
The Day-to-Day:
The Revenue Cycle / Billing Manager oversees the development and implementation of policies and procedures that ensure timely and accurate billing. Ensures current billing practices comply with governmental rules and regulations. Manages the investigation and resolution of billing discrepancies and errors. Implements processes for pricing, billing, third party payer relationships, compliance, and collections to ensure that clinical revenue cycle is effective and properly utilized. Tracks metrics related to the patient engagement cycle including record coding error rates and billing turnaround times to develop sound revenue cycle analysis and reporting.
Matter’s Revenue Cycle Manager will analyze, validate, and track all claims, and quicky identify errors to limit denials. Working to optimize the revenue cycle management process and striving to automate manual task, which in turn will reduce the amount of time between service delivery and payment receipts providing detailed reports and analytics around payment and account receivables to give the organization full revenue transparency.
What Leads to Success?
Responsibilities:
- Plan and direct posting of all services rendered by practice.
- Ensure the accuracy and timeliness of billing amp; collections including charge capture, coding, claims submission, payment, claim rejection and denial management.
- Overall direction, utilization, supervision and instruction of Precertification, Registration/Eligibility, Coding/Charge entry, Account Receivable and Reimbursement.
- Accounts receivable management to identify and resolve billing and/or processing problems timely.
- Develop and implement strategies to improve revenue cycle performance, reduce bad debt, and increase cash flow.
- Serve as internal and external resource for questions regarding patient accounts.
- Partner to develop and implement revenue cycle policies and procedures that ensure compliance with relevant healthcare coding and billing laws and regulations, and third party payer requirements.
- Collaborate with other departments, such as finance, accounting, and compliance, to ensure the accuracy and completeness of financial reporting.
- Work closely with Clinical Leadership to identify documentation and coding gaps for feedback to clinicians practice locations.
- Perform other related duties as assigned.
Requirements
- Passion for Matter Health model, vision, and patient population
- Bachelor's degree or equivalent years of relevant experience in lieu of experience
- Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification
- 4 years outpatient or ambulatory healthcare revenue cycle experience required.
- ·Proven track record of success as an individual contributor in improving revenue cycle performance.
- Effective communication skills to provide clear and actionable feedback to clinicians regarding their documentation and coding
- Knowledge of:
- Medical Terminology, ICD-10, and CPT coding.
- Third party /insurance company operating procedures, regulations, and billing requirements
- Government reimbursement programs
- Negotiated agreements and managed care contracting.
- Provider and Facility Credentialing and working with CAQH profiles
- Business office management and basic accounting principles
Nice to Haves:
- Healthcare organization transitioning to a value-based care model experience
- A working know