Full-Time Sr. Manager, RCM

Senior Manager, Revenue Cycle Management

Under the direction of the VP of Revenue Cycle Management, the Senior Manager, Revenue Cycle Management, is responsible for oversight and training of staff, management of functions and processes and accountable for the team hitting performance, quality and production metrics. The Sr. Manager will support RCM Associate Directors with escalations and larger strategic projects.

Key Responsibilities:

• Ensuring Accounts Receivables are worked according to best practices.
• Reviewing, reconciling, and resolving Manager Holds, Zero Pay, Unapplied, Unpostables, and Aged Accounts Receivable.
• Resolving claim issues that escalate to the RCM team.
• Resolving SalesForce cases and managing related issues.
• Overseeing the claims submission and follow-up process, ensuring accuracy and timeliness.
• Leading and managing large payer projects and care center support projects.
• Keeping ADs informed of improvement opportunities and process improvements.
• Managing teams responsible for accounts receivable (AR), analyzing and resolving aged AR, identifying root cause issues.
• Using data to identify patterns in claim denials/delays, developing actionable solutions.
• Making independent decisions regarding claim adjustments, resubmission, appeals, and claim resolutions.
• Updating RCM policies as needed.
• Meeting with Performance Operations, Implementation, Sales, and other Privia teams to review escalated issues and discuss payer/claim concerns.
• Meeting with Care Center leadership to discuss complex claim/revenue cycle matters.
• Training internal teams (Operations, Sales) and care center staff.
• Supporting care center go-lives (possibly overnight travel).
• Achieving department KPIs, using a team-focused approach.
• Performing/assisting with staffing duties (hiring, termination, coaching, training).
• Providing ongoing performance feedback to staff.
• Counseling employees and obtaining HR assistance for disciplinary actions/terminations.
• Other duties as assigned.

Qualifications:

• High School Graduate, Medical Office training certificate, or relevant experience
• 5+ years experience managing physician revenue cycle
• 3+ years experience in personnel management
• Understanding of revenue cycle optimal performance drivers
• Ability to investigate and resolve complex claims
• Preferred experience with athenaOne, Trizetto, and Salesforce
• Compliance with HIPAA rules and regulations

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