Billing/Revenue Cycle Manager
Manager of Revenue Cycle
Sera Prognostics, Inc. is seeking to fulfill a position of Revenue Cycle Manager through the addition of a talented leader in healthcare billing. This newly created position will be critical to the creation and/or implementation of systems, processes, and teams to facilitate the organization’s strategic initiatives around third-party reimbursement and cash collection. While this position will primarily be responsible for the general supervision and management of the billing department, this team member will also work closely with both finance and commercial leadership to develop strategy for sales targeting, insurance contracting, and revenue forecasting.
The Manager, Revenue Cycle reports directly to the Sr. Director of Systems Integration and will work as a critical collaborator for the Sr. Director in addition to other business leaders through the organization.
- Assist with the identification and implementation of a billing software solution/clearing house and develop organizational processes around third-party reimbursement
- Develop a thorough understanding of organizational systems, processes, and billing requirements, contributing in the proactive identification of opportunities for revenue cycle improvement and enhancement.
- Create and manage the billing operations of claim submissions, adjudication, appeals, and cash collections of patients, institutions, and insurance companies
- Coordinate with the finance department on reconciliation of monthly accounts receivable, revenue adjustments, bad debt, and other reporting
- Assist with hiring, developing, and training of qualified billing employees
- Maintain the billing system, including contract pricing, account valuation, test pricing and coding
- Analyze data to identify trends related to denials and rejections; develops, communicates, and executes plans to reduce/resolve denials and rejections; coordinating closely with commercial leadership in an effort to positively affect strategy of field sales/territories
- General knowledge of ICD-10, CPT and HCPCS coding, DSO reduction, accounts receivable, HIPAA, and EDI claims submission methods.
PREFERRED EDUCATION AND EXPERIENCE
- B.S. Degree from an accredited college or university or equivalent experience.
- 3 - 5 years of experience in the health insurance industry or operations
- 2 years of experience in accounts receivable
- Strong communication skills both written and verbal;
- Demonstrated collaboration and teamwork with internal and external stakeholders;
- Ability to work independently, yet gain the support of diverse commercial groups/partners;
- Ability to successfully respond to an evolving organization and business demands.