Revenue Cycle Manager

Description: Utilizing knowledge of claims and revenue cycle, to manage the daily functions, metrics, and training needed on the NOCD Claims team.  This role requires a self starter work ethic, detail oriented, and is able to successfully prioritize everyday tasks to align with the key performance indicators of the RCM team. 

Responsibilities: 

Oversee Claims team day to day functions and trainings including but not limited to:

• Oversee a team of onshore and offshore claims team, total of 15 Direct Reports
• Maintain, report on, and manage data integration between in-house EMR system and external EHR/Clearinghouses
• Provide assistance to accounting team - monthly reconciliation, audit questions, refund requests
• Lead weekly payer meetings with large accounts - reporting on and communicating issues identified and work alongside insurance representatives to resolve said issues
• Maintain online portal access for RCM team and others throughout the organization
• Enroll and maintain ERA and EFT transactions for 45+ payers
• Training of new employees- make sure they are all set to onboard and have a plan in place to train
• Ongoing training with existing members of claims team-including answering questions and concerns related to daily operations. 
• Daily meetings with the Revenue Cycle Management team to raise large scale issues/concerns that are affecting productivity/profitability/member experience. 
• Identify areas of improvement across claims workflow. Working in the day to day function and allowing consistent feedback from the team will allow you to report and recommend areas of improvement. 
• Quality Assurance-consistently perform quality assurance checks across claims team to ensure optimal results.  
• Coaching of team members when areas of improvement/concern are identified. 
• Management of appeals and refunds
• Project management- ability to take on (assign/work/report) and prioritize projects related to claims as they are needed. 

Skills needed in order to perform job duties:

• Strong claims expertise
  • Understand timely filing rules for initial submission of claim, and timely filing rules for resubmission of a claim for each payer
  • Understand how to troubleshoot denied/rejected/incorrectly paid claims quickly with little to no help
  • Comfortable making phone calls to various payers to inquire about claims/benefits questions
  • Comfortable navigating new payer portals with no assistance
• Advanced in excel 
• Impeccable attention to detail 
• Ability to take large scale data and filter/come up with a way to extract the information needed with little to no support. 
• Strong organizational skills
• Multitasking as a strong suit
• Availability beyond normal working hours 
• Well written communication skills- role requires a lot of cross communication amongst team members and need to communicate concisely and effectively. 
• Ability to work across all levels of organization and departments with confidence