Revenue Cycle Manager

KidsSPOT (Company of Families)

Due to our extreme growth within our pediatric care, we are currently seeking a Revenue Cycle Manager to join our Kid SPOT Family. Because our RC team is expanding, this will allow you to grow and work in a hands-on, entrepreneurial environment. Our core values are to inspire the trust of others and work with integrity and ethics. You can expect all of our team members to uphold organizational values and demonstrate their ability to work through collaboration, teamwork, communication, problem-solving, and decision-making. In this role, the positive impact you will have on children with disabilities will make a lasting difference in their lives and the lives of their family members.

Revenue Cycle Manager Schedule: Monday - Friday Full-time

Revenue Cycle Manager Salary: $60,000.00 annually

ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES:

• Ensures due diligence in the research, analysis, and interpretation of patient medical records to identify and determine amount and nature of billable services, assignment and sequencing of appropriate diagnostic/procedure billing codes for the purpose of reimbursement, in compliance with requirements of third-party insurance payers and accreditation standards.
• Manages the billing process to patients and third-party reimbursement claims; maintain supporting documentation files and current resident addresses.
• Follow up on submitted claims; monitor unpaid claims, initiate tracers and resubmit claims as necessary.
• Monitor billing to ensure compliance with legal and procedural policies and to ensure optimal reimbursements while adhering to regulations prohibiting unbundling and other questionable practices.
• Monitor daily releases and correct errors.
• Review and research inquiries regarding coding, charges, and denials on individual accounts.
• Monitor medical records to identify lost revenue through inadequate documentation.
• Credential providers and ensures consistent compliance with all payer contracts.
• Prepare periodic reports and trend analysis.
• Prepare special reports and research related projects as designated by management.
• Download electronic payments made to us from carriers
• Assist Demographic personnel as needed to determine patient eligibility
• Process bad debts
• Process End of Day and assist to Process End of Month

EDUCATION/EXPERIENCE:

• · 7 plus years of Revenue Cycle Management (RCM) required
• · Medicaid and Commercial experience required
• · SPOT industry experience preferred
• · ABA industry experience preferred
• · Multi-state & multi-site experience required
• · Build, document, and maintain RCM/Billing workflows
• · Must partner with the clinical team on coding & documentation requirements
• · Keeping up with and implementing CMS and payer coding and process updates
• · Track record of successful cash collections
• · Benchmark and minimize DSO, denials, rejections, and the Billing team's productivity
• · Manage Charge Master, Gross to Net, Write-offs, and refund policies, as well as other department policies and procedures
• · Self-starter, able to work with minimal to no supervision
• · Strong in SQL, Excel, and other MS Office programs such as VBA and/or other programming knowledge and experience
• · Excellent planning and organizational skills to balance and prioritize work.
• · Adhere to all Company policies

Location: Remote

Kids SPOT is committed to providing equal employment opportunities to all employees and applicants. Kids SPOT does not tolerate discrimination against job applicants or employees because of race, color, creed, sex, religion, age, national origin, disability, marital status, genetic predisposition or carrier status, sexual orientation, military status, or any other protected class recognized under federal, state, or local law. This commitment extends to all aspects of the company's employment practices including, but not limited to, recruiting, hiring, promoting, transferring, compensation, benefits, training, leaves of absence, termination, and other terms and conditions of employment.

Thank you for taking the time to read and we hope you will finish our quick 3-minute application with Kids SPOT!