Manager, RCM Operations Support AR

ModMed is hiring an RCM Operations Support Manager. The RCM Operations Support Manager for AR will ensure proactive, efficient, results-driven, and cost-effective revenue cycle management; manage the RCM Operations Support team for the related functions, and identify and correct operating issues to maximize success for our physician practice and/or ambulatory surgical center clients. The RCM Operations Support Manager is responsible for all RCM processes related to AR within industry standards and Service Level Agreements. This Manager will support the leadership of RCM by identifying opportunities to increase revenue streams through managing and developing strong teams.

Your Role:

• Direct and manage the daily operation of the RCM Operations AR team to ensure all claims are followed up on and resolved accurately and timely.
• Own the responsibility for any onshore work and support needed to deliver quality services related to AR processes.
• Oversee the RCM Operations Support team of AR Operations Support Specialists. Ensuring continuous evaluation and alignment of resources is top of mind to achieve team success.
• Ensure appropriate Standard Operating Procedures (SOPs), flowcharts, decision trees, and processes are created, maintained, and published by the Operations Support teams.
• Work closely with the Global Services Director to implement efficient and effective workflows with our global partners and global teams to maximize RCM performance.
• Create and implement plans to meet and exceed key performance metrics benchmarks for all clients.
• Conduct recurring meetings to analyze operational and financial results, spearhead any issues, initiate special projects, and identify requirements to improve operational metrics, including meetings with global partner teams.
• Work closely with other BOOST departments to ensure successful RCM service delivery and client experience.
• Work in concert with Sales for pipeline visibility and capacity planning.
• Provide direction in setting and achieving meaningful department objectives supportive of strategic corporate objectives.
• Monitor Client KPIs and progression of performance of the RCM Operations Support team in relationship to SLAs.
• Partner with senior leaders and Talent on all aspects of staffing which includes interviewing, hiring, and training.
• Create an efficient, collaborative, and positive team environment based on trust and accountability.
• Enhance and implement operational business methods consistent with corporate policy, productivity, cost efficiency, and profitability standards.
• Complete other responsibilities, including other administrative projects, as required.
• Reporting:
  • Design and compile periodic revenue cycle reports for management to include analysis of revenue and RCM activity.
  • Focus efforts on trending analysis, dashboards, and ad hoc requests.
  • Collaborate with Business Analysts to ensure accurate client reporting and strategic client management.
  • Review denial management reporting and collaborate on improvements.
  • Ensure review and accuracy of escalation metrics and last-touch reporting.
  • Responsible for review and analysis of meaningful touch rate.

Skills & Requirements:

• Bachelor's degree in Operations, Finance, and/or Accounting required
• Master's degree in Business, Finance, Healthcare Administration preferred
• Medical Billing & Coding Certification preferred
• 7+ years of related experience and/or training or equivalent combination of education and experience.
• Exceptional written, verbal, and interpersonal communication skills are required
• Strong operational improvement skills.
• Demonstrated leadership and training skills, with the ability to impact staff performance positively.
• Ability to motivate, coach, and develop a team as well as the ability to train & guide others in workflows and projects
• Results-driven approach, setting measurable goals for self and the team and holding self and others accountable to achieving success
• Expertise in medical billing, front office, physician practice management, and healthcare business processes.
• Comprehensive understanding of the full revenue cycle process for claim submission, medical insurance policies, and ICD-10 and CPT coding guidelines
• Strong understanding of various insurance carriers, including Medicare, private HMOs, PPOs, Capitation, and Workers Comp.
• Advanced Excel skills such as the ability to use formulas to analyze data, create and format pivot tables and templates, use and conditional formatting and validation functions. Able to create visualizations of data through charts and graphs.
• Mastery of spreadsheets including the ability to manage information located in multiple software systems.
• Ability to demonstrate and assist staff with the development of their Excel skills
• Develop expertise and knowledge in respective ModMed products (PM or gPM) within 5 months of employment.

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