Laboratory/ Physician's Office Revenue Cycle Manager

Job overview

The Revenue Cycle Manager is responsible for coordinating the functional oversight of the revenue cycle operations for the laboratory and provider performed services that are initiated by the Vanguard Laboratory Innovations and Diabetic Center for Excellence business organizations.

This role will serve as a communication and operational liaison between key internal stakeholders (leadership, IT, operational staff) and vendors and will participate in discussions regarding vendor performance, procedural requirements, the implementation of efficiency initiatives, as well as have a key role in decision making as it relates to charge, audit, claim, billing and compliance related determinations made on behalf of the business.

The Revenue Cycle Manager will also work closely with all stakeholders to ensure that accurate and compliant claims are consistently being billed that meet federal and regulatory requirements, and will also act as a training resource, taking proactive steps to identify opportunities for growth and learning for both internal staff and clients.

The Revenue Cycle Manager is also responsible for supporting and helping to execute strategic initiatives, including growth, operations, and revenue focused projects, as needed. This position requires excellent organizational, analytical, and administrative skills, as well as knowledge of either hospital or laboratory operations. The scope of this position requires an ability to communicate clearly, effectively and to manage tasks to the point of completion without immediate supervision and is inclusive of all other administrative duties that are required to support Vanguard Laboratory Innovations and Diabetes Center of Excellence, as needed.

This individual is responsible for adhering to all Vanguard Laboratory Innovations and Diabetes Center of Excellence established policies and procedures, as well as complying with all state and federal privacy and regulatory requirements.

Essential job functions

· Act as a liaison between leadership, and key stakeholders to ensure RCM vendors are meeting expected KPIs as it pertains to organization’s accounts receivable management

· Act as a subject matter expert on revenue cycle related topics; as needed, perform research, review published government guidance and commercial payor communications to assist with resolution of daily business challenges resulting from payor policy updates

· Advanced understanding of medical and laboratory billing and compliance protocols, enabling the ability to support growth and reimbursement initiatives, as needed

· Review billing data to assist in root cause analysis, ensuring effective quality control measures

· Perform ad hoc administrative and project support to support onboarding of new RCM platforms

· The essential functions outlined above are a description of the typical job requirements and is not intended to be an exhaustive list of all possible job responsibilities, tasks, and duties.

Physical Requirements/External Factors

Role requires extensive sitting with periodic standing and walking. Individuals may be required to lift up to 20 lbs. This position requires the extensive use of office equipment including computer, phone, and/or fax, as well as adequate visual and auditory acuity. Position requires dexterity, as well as an ability to communicate verbally and in writing, effectively.

Essential Skills

· Ability to think analytically and conceptually

· Ability to communicate complex issues using strong verbal and written aptitude clearly and efficiently

· Ability to prioritize and complete multiple tasks the high degree of technical and decision-making skills

· Strong organizational, communication and research skills

· Working knowledge of Microsoft Office suite (Word, Excel, PowerPoint, Teams, etc.)

Minimum Qualifications

· Associate’s degree or equivalent professional experience (two years of laboratory/medical billing operations)

· In-depth understanding of HIPAA privacy laws and compliance practices

· Knowledge of basic medical billing protocols and procedures in conjunction with federal and state regulatory policies and guidelines

· Intermediate knowledge of hospital and/or laboratory operations, computer systems and analytical software and medical billing processes

Preferred Qualifications

· Bachelor’s degree or equivalent professional experience (four years of laboratory/medical billing operations)

· Advanced knowledge of hospital and/or laboratory operations, computer systems and analytical software and medical billing processes

· Familiarity with laboratory and physician credentialing requirements and procedures

· Advanced working knowledge of Microsoft Office suite (Word, Excel, PowerPoint, Teams, etc.)

· Familiarity or certification in ICD-10, CPT, and/or HCPCS coding

· Significant understanding of pathology, genetic, and basic clinical laboratory testing

· Knowledge of project management concepts and tools

Job Type: Full-time

Pay: $72,000.00 - $79,000.00 per year

Benefits:

• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Work Location: In person

Salary : $72,000 - $79,000