Senior Manager of Revenue Cycle Management (RCM)

Advantia Health is seeking a Senior Manager of RCM to Work under the supervision of the VP of RCM, the Senior Manager of RCM. This role will require up to 50% travel amongst all Advantia locations.

• Leads an RCM Call Center team that handles phone calls from Advantia’s patients about their financial obligations (such as copays, coinsurance, deductibles, and services not covered by insurance), and works with patients to collect same.
• Helps Advantia develop a Central Billing Office (CBO) to perform Practice-level RCM functions on a centralized basis, more effectively and efficiently, over time.
• Along with other management and specialists in the CBO, supports Practice-level RCM staff, that perform charge entry, coding, claim generation, denials management, and time-of-service patient responsibility collections. Helps Practice-level RCM staff implement best practices, and trouble shoot RCM issues.
• Obtains appropriate levels of support and responsiveness from Advantia’s RCM vendors, including R1 (coding and denials management), Athena (EMR and billing), Phreesia (online visit check-in and patient responsibility collections), collections agencies, and others. Assists these vendors where needed, in working with Advantia’s internal RCM staff.
• Initiates and leads payer projects with patients’ insurance plans, to resolve reimbursement issues and any backlogs. Along with other management and specialists in the CBO, supports all web-access and payor portal issues.
• Focuses on achieving Advantia’s RCM goals for cash collection, coding accuracy, denials management, write-off minimization, and Accounts Receivable (AR) Days Sales Outstanding (DSO). Establishes and achieves call center metrics such as hold time, abandon rate, and staff productivity.
• Ensures compliance with all pertinent company and regulatory requirements, policies and guidelines.

Job Responsibilities:

• Promotes and supports a working environment consistent with the standards, values and culture of Advantia.
• Strong leadership skills, in a multi-site and highly matrixed environment. Able to provide highly effective leadership in multiple dimensions, with direct reports, colleagues in corporate and Practice offices, senior leadership, vendors, payers and others.
• Strong customer service orientation, with a passion for providing excellent service to Advantia’s patients and their families, and to all internal RCM stakeholders.
• Leads RCM projects with team members from across Advantia and vendors. Establishes project goals, tasks, owners, interdependencies, and deadlines. Leads teams to successful achievement of RCM goals.
• Performs workflow analysis and develops Standard Operating Procedure (SoP) documentation, as needed to support Job Duties as described above. Trains colleagues in SoPs.
• Analyzes data and reports from vendors and systems such as R1 and Athena, to identify and troubleshoot problems, and to help colleagues better understand RCM challenges and actions needed to resolve same.
• Leads and manages a team of direct reports, including the RCM Call Center. Hires, trains, develops, and holds accountable, all direct reports.
• Strong written and verbal communication skills. Able to help develop clear and insightful status and update presentations for all levels of the organization, from Board and CEO, to peers and vendors.
• Supports the Accounting team by providing guidance and subject matter expertise, as needed, to achieve timely and accurate Revenue Recognition.

Job Requirements: 

• 7+ years of progressive RCM experience, including a management role in a Central Billing Office (CBO) for a Physician Practice Management (PPM) company. OB GYN Practice experience a plus but not required.
• Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) or Certified Coding Specialist-Physician (CCS-P) Preferred but 2-3 years hands on experience working as a physician medical coder will be considered.
• 3+ years of recent experience working with the Athena EMR system strongly preferred.
• Experience with Phreesia online patient visit registration and payment system, is preferred but not required
• Deep knowledge of Managed Care and Managed Medicaid reimbursement for PPMs.
• Strong ability to multi-task in a fast-paced, multi-site, highly matrixed environment.
• Well-organized with ability to prioritize.
• Attention to detail and problem-solving ability.
• General knowledge of the Centers for Medicare & Medicaid Services (CMS) regulations.
• Bachelor's degree in a health-related field or business administration; MBA or advanced degree desirable. Coding certification a plus but not required.

Please note: Advantia Health is dedicated to providing unparalleled healthcare to our customers by employing the most highly qualified individuals. If you are selected for further consideration, you will be subject to a background investigation. COVID-19 and Flu vaccination is a required condition of employment.

Advantia Health is an Equal Opportunity Employer that is committed to global diversity: It is a place where good people want to work, and customers want to continue to engage EOE M/F/D/V.