RCM Supervisor - Accounts Receivable

October 5

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Home Care Aide • Personal Care Aide • Respite Care • Nursing Care (RNs, LPNs, CNAs) • Transportation Services

4907 - 4907

Description

• Direct team of AR Representatives. • Ensure that client billing data is accurately entered into the system, including payor information and service charges prior to invoicing/exporting claims. • Submit claims to payors in accordance with payor requirements and agency policy. • Supervise claim rejection and denial process by maintaining complete and accurate accounts receivable records to ensure claims are submitted and paid in full. • Review SFTP file logs to ensure all file transmissions are successful, resolve any unsuccessful transfers with the appropriate parties. • Analyze daily remittance reports from the state/managed care organizations and reconciling the approved payments. • Must be able to: identify missing or pending invoices or remittances. • Create an aging report for follow up with the state/managed care organizations. • Maintain accurate billing analysis reports and communicating implications promptly to the appropriate parties. • Review all write off, refund and takeback requests. • Communicate with the state and managed care organizations for resolution of issues and submission of exception requests, disputes and appeals. • Make decisions and solving problems - analyzing information and evaluating results to choose the best solution. • Conduct staff meetings at regular intervals for informative and educational purposes. • Perform other related duties as assigned.

Requirements

• Bachelor's degree in accounting, finance, economics or a related field. • Three (3)+ years’ experience of revenue cycle management or billing experience in the healthcare field. • Knowledge of Medicaid/Managed Care Organization (MCO) billing practices. • Experience with billing in an Electronic Data Interchange/3rd party clearinghouse environment • Knowledge of Data Flex, HHAeXchange, MCO portals and Waystar (Zirmed) is preferred.