RCM Account Manager

Responsible for the management of all aspects of billing operations to include, but not limited to; billing, collections, reimbursement, charge entry and customer service for designated clients. Must be experienced in all facets of the billing process including but not limited to; charge entry, claim edits, electronic transmittal, electronic receipts, billing and accounts receivable report analysis, claim processing, insurance verification, cash reconciliations, collections from insurance companies as well as patients.

Responsibilities:

• Responsible for the daily management of staff and the day-to-day operations related to billing.
• Monitor daily production department goals by setting clear expectations and holding staff accountable to those expectations
• Develop new employees and existing employee training, provide on-going formal feedback to all staff members, and clearly outline performance expectations.
• Continuously develop and foster a supportive work environment.
• Organize staff to adequately perform daily functions.
• Responsible for developing specific and measurable metrics to monitor staff and client performance which include developing reports and action plans.
• Ensure all staff are trained to operate the billing system.
• Ensure all staff are educated on applicable payer specific guidelines and utilize consistent billing policies.
• Identify staff within practices who require additional training.
• Consistently analyze billing operations by reviewing daily, weekly and monthly system reports to identify trends in A/R and payor mix
• Develop, implement and manage policies and procedures for daily billing activities and best practices in regards to billing
• Continually assess staffing needs based on client's projected budget
• Directly responsible for ensuring positive customer relations with the client
• Communicate with physicians, payers, patients, and administrative staff within practices as required
• Perform other duties as assigned to maintain departmental functions
• Provide strategic insight and recommendations on maximizing cash collections to AR Manager/Director
• Identify and resolve insurance claim denials
• Keeping abreast of payer/carrier rules and regulations (Self-pay HMO/PPO and Gov’t payers)
• Keeping upper management abreast of both successes and problems as they occur.
• Maintenance of adequate staffing levels
• Counseling sessions and disciplinary write-ups

Secondary Functions:

• Participate in various committees as required
• Participate in problem resolution at all levels
• Be a role model within the department by exhibiting mature leadership qualities such as a positive outlook, confidentiality, respect, and team spirit.
• Attend meetings as required
• Assure that HIPAA compliance guidelines are followed
• Ability to cover and perform all duties in the absence of employees.
• Other duties as assigned by Sr. Account Manager/Director/VP RCM.

Supervisory Responsibilities

• Billing Specialists, Payment Posters and Data Entry Clerks

Skills/Qualification:

• High school diploma/GED
• Bachelor’s degree in a business-related field is strongly desired.
• Minimum of three years’ experience managing employees in a AR healthcare environment
• Minimum of two years’ experience in physician professional billing (Managed Care, Commercial and or CMS Part B claims adjudication

Core Competencies:

Accountability and Self-Management

• Must be detail-oriented and organized
• A self – starter capable of tracking to deadlines and meeting goals with little supervision required
• A high level of analytical and problem solving skills is expected

Teamwork and Leadership

• Must be able to display outstanding leadership skills
• Must work autonomously with little or no supervision

Communication

• Must demonstrate very good communication, customer service, and organizational skills
• Very good verbal and written communications is desirable
• Ability to conduct department presentations

Reasoning Ability, Problem Solving and Innovation

• Is expected to apply appropriate reasoning to their decision regarding their approach to managing the AR of their assigned work
• Is expected to communicate persuasively, both orally and in writing.

Computer Skills

• Must possess general office skills and computer knowledge
• Strong working knowledge of the Next Gen EPM practice management system and or GE Centricity Business system and coordinating modules, is preferred
• MS Excel Spreadsheet software, MS Word Processing software and MS Power Point software.

Physical Demands:

• May require sitting for long periods of time; also, stooping, bending, and reaching for files and supplies.
• Requires manual dexterity sufficient to operate a computer keyboard, answer a telephone, and run a copier and other office equipment as necessary.
• Employee must participate to help maintain the desirable work environment created by the management and company officials.