What are the responsibilities and job description for the Revenue Cycle Manager position at Wellinks?
About
Wellinks is the COPD disease management company committed to empowering people to live fully and breathe freely by improving outcomes for those we serve. We are creating a future where COPD care is designed and delivered around the individual and supported by a team striving to help them live a healthier, more fulfilling life. Our partners choose Wellinks to deliver a tailored and personalized healthcare experience for their members, resulting in improved outcomes at lower costs.
Wellinks is a high-growth company that is rich with mission-driven talent, guided by passionate healthcare leaders, and backed by world class investors. We are headquartered in New Haven Connecticut, conveniently between Boston and New York, and have team members across the US.
About the role
- As the Revenue Cycle Manager, you'll be responsible for processes and strategic initiatives associated with Revenue Cycle Management at Wellinks. Reporting directly to the EVP Finance, you'll oversee end-to-end revenue cycle operations, including, but not limited to enrollment activities, insurance verification, authorization and referral requests, research and follow up on claim denials. Assist with internal and external (customer, practice, patient) communication as they relate to coverage, changes of insurance, and claim management. You will also identify and implement best practices in RCM and related processes.
- With a customer-centric focus, you'll directly collaborate with clients, monitor key performance indicators, analyze financial performance, and lead impactful project management initiatives. Supporting finance, you'll manage accounts receivable and collaborate for seamless financial operations.
What you'll do
- Revenue Cycle Management: Oversee end-to-end revenue cycle operations, from coverage determinations to charge entry to reimbursement.
- Data Processes: Extract, assess, and qualify patient data from the customer, perform cleanup, and upload into internal systems for enrollment, ensuring sustained data accuracy and maintenance.
- Coverage Determinations: Verify eligibility (either electronically or with calls to insurance companies), ensure RPM coverage, copay and deductible amount, other out of pocket costs, and if authorization/referral is required.
- Billing Operations: Delivery accurate and timely billing services to our clients. Implement and maintain billing systems and software to support efficient operations. Support finance in effectively managing accounts receivable.
- Compliance and Quality Assurance: Ensure compliance with healthcare regulations and billing guidelines. Establish and enforce quality assurance measures to guarantee accurate and ethical billing practices.
- Technology Integration: Work closely with the technology team to integrate billing systems with customers. Identify opportunities for automation and technological enhancements to streamline billing processes.
- Customer Centric Focus: Collaborate with clients to understand their billing needs and provide support and education, as necessary. Serve as a subject matter expert on billing-related inquiries and concerns.
- Performance Metrics and Reporting: Monitoring key performance indicators (KPIs) to gauge the effectiveness of revenue cycle and billing operations. Regularly analyzing and reporting on financial performance, identifying trends, and areas for improvement.
Minimum Qualifications
- Bachelor's degree is required
- Minimum of 5 years of experience in billing and revenue cycle, specifically within the healthcare sector.
- Comprehensive understanding of healthcare billing regulations with both Governmental and Private Payers, compliance requirements, and industry best practices.
- Ability to stay organized, work quickly and accurately, learn new platforms and processes, adapt to change, and ability to multitask.
Preferred Qualifications
- Experience with EHR and billing systems (i.e. - Epic, AthenaHealth, Cerner, eClinicalWorks)
- Experience using Salesforce
- Experience with elderly patients
- Must be available to work on site at the Company’s New Haven, CT headquarters
The pay range for this role is:
50,000 - 70,000 USD per year(New Haven)
