Revenue Cycle Manager

Summary

Join Forge Health as the Manager (Director) of Revenue Cycle Management, leading daily operations for patient eligibility, charge entry, accounts receivable, and invoice management. You will drive effective billing performance, manage a team of approximately 11, and collaborate with internal and external partners to resolve billing issues. Leverage data to provide performance insights and inform business decisions. This remote position requires a Bachelor's degree (Master's preferred), seven years of relevant experience, strong analytical skills, and leadership abilities. Forge Health offers a competitive benefits package including paid time off, parental leave, continuing education allocations, and comprehensive medical, dental, and vision coverage.

Requirements

• Bachelor’s degree in healthcare administration, business, finance, or a related field
• At least seven (7) years of experience in revenue cycle management in healthcare in positions of increasing responsibility
• Experience working with commercial health insurance companies, Medicaid programs, and Medicare programs
• Strong analytical and problem-solving skills, with the ability to interpret complex financial data and trends to develop effective revenue cycle strategies
• Demonstrate comprehension of payor contracts, with special attention to complexities and details
• Excellent leadership abilities, with a track record of building and motivating high-performing revenue cycle teams within addiction treatment facilities
• Solid understanding of healthcare regulations, including HIPAA and confidentiality requirements specific to substance abuse treatment
• Proficiency in revenue cycle management software and systems, with the ability to leverage technology for process automation and efficiency

Responsibilities

• Actively manage billing work inventories relates to mental health and substance use disorder services with commercial health plans, state Medicaid and managed-care organizations, and Medicare
• Proactively identify situations which require intervention (i.e. denials, underpayments, and other issues). Plan, prepare, and conduct corrective course of action(s) in partnership with key stakeholders
• Make corrections to staff execution and/ or business process challenges that lead to revenue collection delays
• Ensuring that patient insurance eligibility is actively managed to ensure smooth billing experience for patients and effective submission to the applicable insurance companies
• Effectively utilize available data to identify key performance theme and trends
• Active coaching and development of teammates as it relates to their direct performance of defined objectives as well as their professional development
• Fostering a team environment that promotes performance, belonging and engagement
• Ensure that the Revenue Cycle team executes the defined processes in accordance with applicable regulations, policies and procedures
• Partner with leadership to develop, recommend, and implement payor contracting strategy for fee-for-service and value-based initiatives with commercial health plans, Medicaid, and Medicare partners – actively providing data to senior leadership for negotiations with existing and new payor partners
• Identify and ensure revenue cycle management training needs at all levels of the organization, and foster change to achieve performance improvement initiatives
• Prepare impactful reports, analytics, summaries, and visualizations to communicate findings

Preferred Qualifications

• Master’s degree
• Experience in revenue cycle management in behavioral health
• Professional certifications in revenue cycle management or addiction treatment billing

Benefits

• Competitive salary aligned with your experience
• Comprehensive paid time off package
• Annual time off to volunteer
• Parental leave
• Annual continuing education allocations
• Competitive medical, dental, and vision package
• Annual subscription to a leading meditation app
• An environment that fosters professional development including financing for advanced licensure and certifications
• Internal supervision opportunities
• Dedicated, motivated team and chance to be part of a highly ambitious medical startup
• Modern, elegant, and high-end work environment