Integra is seeking a results-oriented, dynamic, proven health care, operations professional, capable of managing and leading a large claim production team in the healthcare industry. This role is responsible for real time management of claims pricing, revenue cycle management of appealed and denied claims.
The RCM Manager will be accountable to identify and generate value and scalability, while providing expertise on claims support to teams in reviewing, researching, investigating, processing, and adjusting claims. The RCM Manager will be responsible for Production and Inventory, developing leadership for the RCM team.
The RCM Manager must be skilled in process improvement, decision making, personnel management, and have previous production leadership experience in the healthcare industry. This role will require direct collaboration and influence with leaders across Integra Partners to drive ideation, strategy, execution, and delivery.
Salary: $75,000/Annually
JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES
The RCM Manager’s responsibilities include but are not limited to:
- Responsible for real-time management of department task and production.
- Achieve First in First out with claims inventory and work towards 24-48 hr. turnaround on incoming claims.
- Provide leadership to RCM supervisors, inventory and RCM agents.
- Evaluate the department tasks to determine appropriate team structure and allocation of work for greatest efficiency.
- Develop a comprehensive DME claim program with respect to Medicaid, Medicare and commercial billing/payment guidelines.
- Partner with the training team to develop a curriculum and new hire on-boarding process to ensure the team has the right tools and knowledge to perform their tasks.
- Develop goals and objectives for the department and rollout strategy to obtain the established business outcome.
- Oversee monitoring and tracking of key performance metrics against established goals and coach/ guide the management team to achieve success, including but not limited to meeting timely filing requirements.
- Continually look for opportunities to automate routine Revenue Cycle Management tasks through technology.
- Serve as the subject-matter expert on regulatory, compliance, and legal requirements associated with medical billing and CMS
- Ensure clear metrics are defined, measured, and reported for tracking and trending Claims outcomes
What will you learn in the first 6 months?
- In the first six months you will learn the function of the RCM department within the organization and be fully integrated in your position, company and team.
- You will have a full and complete understanding of our metric requirements and reporting capabilities.
- You will understand your role and responsibilities, to foster excellence in team performance.
- You will work towards achieving departmental goals and monitor progress as you build relationships with your team to encourage and understand individual needs and abilities.
What will you achieve in the first 12 months?
- You will create a people-first approach to your team, easily identifying the strengths and weaknesses of each team member and how to best support them.
- You will personalize your feedback to provide constructive and supportive feedback.
- You will contribute your skills and knowledge to meet your department’s metrics and goals.
- You will conduct weekly huddles and host regular monthly one-on-one meetings with agents for mutual feedback and to establish strategies for development/growth.
EDUCATION: Bachelor’s degree or equivalent experience
EXPERIENCE:
- Experience working within Revenue Cycle Management
- DME-focused claims experience preferred
- 5+ Years of relevant experience in a fast paced, healthcare environment
- 5+ Years of leading teams of 5+ people to outstanding results
- 5+ Years Claims and AR Resolution Experience
- Outstanding interpersonal and communication skills
- Pro-active, results oriented, adaptable individual striving for everyday excellence
- Able to manage multiple, complex projects
- Strong analytical and reasoning skills
- Ability to work effectively with internal and external clients to increase satisfaction with company and department’s performance
- Curious, adaptive, focused, able to change and grow
- Leader comfortable hiring and developing high performing teams
What We Do
Integra Partners is a leading network management company that connects Orthotics and Prosthetics (O&P) and Durable Medical Equipment (DME) providers with health plans and their patients. The company works with more than 50 health plans and has over 4,000 provider locations in its network.
For more information on Integra Partners, visit www.accessintegra.com