Revenue Cycle Manager

Summary

Join Tia, a healthcare innovator focused on transforming women's healthcare, as their Revenue Cycle Manager. Oversee the entire credentialing process and the backend revenue cycle, from rejections to payment posting. Lead a team to ensure effective provider tracking and contract setup, establishing optimal systems and procedures. Identify and resolve revenue leakage, minimizing rejections and denials. Create key performance metrics and ensure the team operates at the highest level. This role requires strong leadership, collaboration, and problem-solving skills, along with experience in revenue cycle management and team leadership. The position offers a competitive salary and benefits package.

Requirements

• Leadership and Team Management : The ability to lead a diverse team of talented individuals, access their strengths, weaknesses, & preferences and engage them in the best possible strategy to ensure that they are empowered to succeed as an individual and help the department and organization thrive as a whole
• Dynamic cross functional collaboration : Use of organizational & RCM department historical knowledge context and nuance to engage with the optimal partners to create novel solutions to complex problems
• Lead a healthy culture : Foster a culture within the team of belonging, trust, and accountability that helps to bring out the best out of not only the team but also our cross functional partners
• Process Development & Optimization : Design processes to enhance efficiency, and overall performance. Ability to analyze existing workflows, identify bottlenecks, and implement improvements
• Policy Development : Craft actionable & effective policies that align with organizational and departmental goals. Skilled in conducting thorough research, collaborating with stakeholders, and synthesizing information into clear and actionable policies
• Implementation and Tracking of Operating Procedures : Lead the implementation of new operating procedures. Develop detailed plans, coordinate with cross-functional teams, and provide training to ensure successful adoption. Additionally, skilled in establishing robust tracking mechanisms to monitor procedure effectiveness and identify areas for refinement
• Problem Solving : Tackle complex problems with a systematic and analytical approach. Capable of swiftly identifying root causes and implementing novel solutions. Adaptable problem-solver who thrives in dynamic environments, leveraging a combination of critical thinking, analysis, and collaboration to drive continuous improvement
• Communication and Collaboration : Exceptional communication skills, both verbal and written, with the ability to convey complex ideas in a clear and concise manner. Proficient in fostering collaboration across teams and departments through effective interpersonal communication. Skilled at building relationships, actively listening to diverse perspectives, and facilitating open dialogue to ensure cohesive teamwork and successful project outcomes

Responsibilities

• Team Leadership Lead a team of credentialing specialist & billing leads providing guidance, coaching, and direction on collaborative and high-performance culture in the function
• Performance Metrics: Establish and monitor key performance indicators (KPIs) to measure the effectiveness and efficiency of the billing & credentialing team. Analyze performance metrics and implement initiatives to achieve and exceed organizational targets
• Identifying & resolving areas of revenue leakage: Identify and resolve potential areas of revenue leakage within the revenue cycle. Utilize a strategic and data-driven approach to analyze financial processes, proactively identifying gaps and implementing targeted solutions. Collaborate with cross-functional teams to ensure the seamless integration of initiatives
• Rejections and denials Lead a dedicated team focused on minimizing rejections and denials by implementing robust operations for claims submission and validation. Develop and implement measures to address rejections, reduce denials, and optimize the claims process to maximize reimbursements. Utilize reporting and analytics to identify patterns and implement actionable solutions
• Under payments (incorrect payments) Establish a process to identify underpayments, review payment discrepancies, and work with stakeholders to ensure that all payments align with contractual agreements and fee schedules
• Payment posting/Lockbox management Ensure accurate and timely recording of payments, specifically virtual credit cards and checks from our lockbox system are being recording in our patient accounting system and in our data
• EDI / EFT Enrollment Oversee the enrollment process for Electronic Data Interchange (EDI) and Electronic Funds Transfer (EFT) with payers. Develop and maintain strong relationships with market partners & payers to facilitate smooth enrollment processes
• Credentialing and enrollment Lead a dedicated credentialing and enrollment team to ensure timely and accurate provider credentialing with various payers. Implement best practices to streamline the enrollment process, reducing delays and ensuring uninterrupted revenue streams. Stay current on industry regulations and payer requirements to maintain compliance throughout the credentialing lifecycle
• Payer management Develop and maintain effective relationships with market partners, and payers. Collaborate with cross-functional teams to address payer-related challenges

Benefits

• Unlimited vacation
• Free Tia membership
• Competitive stock option package
• $300 one-time WFH stipend
• $50/month phone and internet reimbursement
• Medical, dental, and vision benefits
• 401k program (no matching at this time)
• Top of the line 13" Macbook Pro
• Travel stipend for team off-sites