Position SummaryBlue Ridge Cancer Care has an exciting opportunity for a FT Revenue Cycle Manager for the
Roanoke, VA location.
Blue Ridge Cancer Care is an affiliate of The US Oncology Network that extends an extremely competitive offering
of benefits to employees, including Medical Health Care, Dental Care, Vision Plan, 401k, Life Insurance,
Short-Term Disability, Long-Term Disability, Wellness and Perks Program.
Come join our growing organization and enjoy knowing that you work for an organization dedicated to
making the lives of others better.
Responsible for maximizing the collection of medical services payments and reimbursements from patients, insurance carriers, financial aid, and guarantors. Responsible for insurance eligibility processes; charge processing; claim submission and processing; payment processing; collections and accounts receivable management; denial management; reporting of results and analysis; concurrent and retrospective auditing; proper coding; credentialing; insurance contract review and oversight; customer services relative to revenue cycle; training and development relative to revenue cycle; analytics, and all other revenue cycle management activities. Supports and adheres to the US Oncology Compliance Program, to include Code of Ethics and Business Standards, and US Oncology’s Shared Values.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Management oversight of all business related functions of the patient visit from point of entry to accurate adjudication of the patients’ accounts. Specific areas of responsibility include Revenue Cycle Training, Credentialing, Registration, Claims Management, Billing, Collections, Patient Insurance, Data Processing, Integrity of Patient Accounts, Accounts Receivable Management, Practice Management System fFle Maintenance, and Third Party Revenue Cycle Vendors.
-Responsible for provider reimbursement programs, policies, and strategies to ensure unit cost controls meet or exceed corporate objectives for medical cost containment. Analyzes claims, utilization, and medical cost data. Develops strategic, cost effective programs, and makes system or network changes to enhance competitive position.
-Monitors aged accounts and verifies appropriate collections procedures are being followed. Manages revenue cycle projects at the Practice level, such as audits and budgets.
-Regularly provides upper management with revenue cycle status including reports, metrics, and presentations. Develops, monitors, and assesses business metrics in order to refine processes and improve efficiencies. Establishes internal goals and identifies external benchmarks.
-Resolves escalated reimbursement issues with Payers, Practices, US Oncology and systems for optimal management of accounts receivable. Challenges the status quo and champions new initiatives; acts as a catalyst of change and stimulates others to change; paves the way for needed changes; manages implementation effectively. Steps forward to address difficult issues; puts self on the line to deal with important problems; takes ownership.
-Develops, implements, and maintains the Practices revenue cycle standard operating procedures (SOPs). May develop training materials and facilitate staff training of SOPs, systems, metrics, government regulations, and etc.
-Responsible for the overall coordination of front office duties to include scheduling, check-in, and co- pay/co-insurance collection.
-Identifies goals and vision for team; guides individuals and teams toward priorities; clarifies roles and responsibilities of others; coordinates resources and arranges organizational systems to meet objectives. Develops and implements progressive short term goals that align with the company’s vision and business goals. Cascades goals down to staffs’ annual objectives.
-Attracts high caliber people, accurately assesses strengths and development needs of employees; gives timely, specific feedback and helpful coaching; provides challenging assignments and opportunities for development. Responsible for interviewing, recommending hires, assessing performance, recommending salary changes, and progressive discipline. Enforces adherence to the Practices' and US Oncology’s policies.
-Other duties as requested or assigned.
Bachelor’s degree in Finance, Business, or equivalent OR 8 years of revenue cycle management experience required. At least four (4) years of medical revenue cycle management experience required with a consistent track record of achieving metrics and at least two (2) years supervisory experience successfully resolving a variety of people issues. Overall revenue cycle experience should exceed nine(9) years. Individual must have strong knowledge of medical insurance billing and collections with CPT, ICD10, and HCPCS coding and medical terminology, as well as an overall understanding of managed care products (HMO, PPO, etc). Proficiency in Microsoft Office (Outlook, Excel, Word, and PowerPoint).
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. Requires full range of body motion, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs.
Requires corrected vision and hearing to normal range.
The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites.
The US Oncology Network is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.