Manager, Revenue Cycle Management

DispatchHealth is redefining healthcare delivery through mobile and virtual healthcare. We provide right-sized healthcare through the power of technology, convenience, and service. DispatchHealth is creating an integrated, convenient, high-touch care-delivery solution that extends the capabilities of the patient's care team and ensures that we provide personalized, quality care in the home or at the patient’s location of need. 

 The Manager, Revenue Cycle Management, within DispatchHealth’s Revenue Cycle Department, has responsibility for management and oversight of Billing, Technical Claim Denials and Appeal functions.  

• Providing effective supervision, including monitoring, training, work allocation, evaluation, and problem resolution. 
• Assisting in designing, executing, and ensuring policies and procedures are adhered to. 
• Fine tuning effective billing/intake processes for improvement. 
• Coordinating and directing the activities of the billing operations, denial management and self-pay collections following overall departmental protocol; and ensuring compliance with that State, Federal, and payer requirements, guidelines, and regulations. 
• Overseeing billing and patient collection and technical denial vendors, including assignment of work and prioritization, reviewing and managing contract deliverables. 
• Planning and directing data processing and billing and collection to achieve efficient account and accurate billing. 
• Assisting in resolving claim submission issues, and payer issues, to include appeals of accounts, and working with other areas within the RMC department. 
• Working with other areas within the RMC department. 

Essential Duties and Responsibilities  

 Billing  

• Oversee and streamline billing and collections processes 
• Facilitate accurate and timely billing and resolution of issues by working with designated company personnel to include internal and external customers. 
• Manage the process of collecting receivables 
• Design, develop, and continually improve billing processes. 
• Identify and implement process and system improvements/enhancements in billing to drive system automation. 

Denial Management  

•  Responsible for the analysis, interpretation, and identification of insurance denials and related performance variations and opportunities. 
• Responsible for development and execution of denials prevention plan to anchor denials resolution processes in the analyses of core analytics to identify root causes and identify proactive and sound approaches. 
• Informs improvement goals through timely review, interpretation and categorization of monthly denial and write-off trends and issues. 
• Promotes collaborative practice with revenue cycle stakeholders and facilitates data sharing that provides insight into where best to focus concentrated denial prevention and management efforts. 
• Identifies and communicates payer specific issues for escalation. Facilitate the dissemination of information regarding government and third-party payor regulations and requirements to clinical departments, coding, billing, revenue cycle management and staff, as applicable. 
• Monitor performance metrics against best practice targets. Influences development of denial reporting tools. 
• Perform other related duties as directed 

Leadership 

• Demonstrates effective supervisory skills, including developing clear performance expectations, coaching, and resolving performance problems 
• Communicates honestly and courageously; transparently shares own positions and needs. Brings tough issues to the surface, even when uncomfortable. 
• Demonstrates inclusive behaviors in their daily leadership style and through active collaboration. 
• Sets direction and expectations clearly 
• Measures and documents performance 

Additional duties as assigned 

Qualifications 

Education and Experience 

• High school diploma or equivalent required 
• Bachelor’s degree in healthcare administration, Business, or related field. 
• Minimum one: (3) year billing and accounts receivable management experience in a medical facility, ambulatory surgery facility, or acute-care hospital required. 

Preferred Qualifications: 

• 2 years of supervisory/ managerial experience preferred. 
• Master’s Degree preferred. 

 Skills/Abilities 

• Advanced competency in MS Office and Excel 
• Clear understanding of Federal, State and NCQA time frames and other contractual legal requirements. 
• Knowledge of CPT, HCPCS, ICD-10 and medical terminology preferred. 
• Ability to Identify trends within denials and appeals and provide results to internal committees, CMS and the State as required by contract 
• Thorough knowledge of patient financial services (PFS) processes and standards related to billing, collections, and cash posting. General knowledge of patient registration, finance, and data processing. 
• Strong analytical and problem-solving skills. 
• Excellent communication skills, both written and verbal, and internal personal skills 
• Excellent analytical and problem-solving skills 
• Strong customer service orientation and attention to detail 

 Physical Demands 

While performing the duties of this job, team members are regularly required to sit, stand, walk, reach with hands and arms, and to talk and hear. Team members may be occasionally required to climb or balance, stoop, kneel, or crouch. Team members must occasionally lift, push and/or move up to 30 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. 

Work Environment 

This position is considered remote with possible travel to practice locations in other states. The noise level in the work environment is typical of an office setting.  

The above describes the general content of and requirements for the performance of this position. It is not intended to be an all-inclusive statement of the duties, responsibilities, and requirements of the position.