Accounts Receivable Manager - Medical
Atlanta, GA | Billing
Position Summary:At GoHealth Urgent Care, we place the needs of our patients first - by providing an effortless patient experience, a welcoming culture of care and seamless integration with market-leading health systems and our communities.
Assignments received from: VP Revenue Cycle, Director Revenue Cycle
Positions supervised: Yes
The Revenue Cycle Manager manages all functions of the organizations billing and revenue cycle to maximize cash flow while maintaining and improving internal and external customer relations. Supports, maintains, manages, and monitors the revenue cycle activities for the physician practice including Charge Capture, Claim Production, and Denial Management.
The manager assures all established billing, systems, and workflow requirements have been met in order to ensure an efficient and streamlined revenue cycle. Responsible for the coordination of these efforts together with site personnel to ensure accuracy and timeliness.
This role participates in the review of the Entity Revenue Cycle results, including (but not limited to) Charge Edits, Denials, Net Revenue Realization, and Days in A/R. The Manager works to implement leading practices and operations that will positively impact the Revenue Cycle and help the Central Business Office operate according to industry benchmarks. In addition, the Manager will work to ensure GoHealth’s Revenue Cycle policies and procedures are followed in the multiple markets.
- High School Diploma or GED required
- Bachelor’s degree in Science, Business or a related field preferred.
- In lieu of degree, six (6) years of relevant work experience will be accepted in addition to the experience requirement required
- Five (5) years of experience exhibiting advanced performance in a physician billing revenue cycle or Central Business Office
- Three (3) years of leadership/management experience
- Advanced knowledge of third-party insurance, and familiarity with insurance plan types; HMO, PPO, POS, and Indemnity.
- Thorough knowledge of Medicare Fraud and Abuse regulations as well as HIPAA regulations.
- Possesses advanced knowledge of Practice Management Systems with expertise in billing.
- Detailed and process improvement oriented.
- Strong knowledge of the Accounts Receivable process
- Ability to work both independently and as a member of a team to solve complex revenue cycle issues.
- Ability to apply complex analysis and interpretation in order to assess issues involved in the financial and technical aspects of medical practice revenue management, including coding, billing, reimbursement and collections metrics, policies and procedures.
- Facilitates project management, on-going support, follow-up analysis and implementation support for projects with widely varying scope.
- Presents and communicates in a professional and effective manner.
- Clear and effective written and verbal communication skills.
- Skill and ability to handle multiple priorities and deadlines.
- Strong aptitude for adaptability and flexibility in dynamic environments.
- Strong demonstration of applied project management rigor.
- Demonstrated proficiency in the use of business support software applications such as MS Office (Word, PowerPoint, Excel, Visio, etc.).
- Prepares periodic and/or as requested status reports that quantitatively and qualitatively inform of project progress and results.
- Ability to analyze data and present findings to reporting director.
- Ability to develop and manage projects and workflow re-engineering.
- Excellent phone, communication, organizational skills, computer skills and mathematical skills
- Ability to maintain patient confidentiality
- Strong problem-solving skills and ability to make timely decisions
- Additional Knowledge, Skills, and Abilities Preferred ï‚§ Epic or eClinicalWorks experience
- Experience with Microsoft Excel and Word
- Maintain Daily communication with direct reports and team leads.
- Maintain a high level customer service approach to working with Accounts Receivable Specialists, payors and centers
- With support of the Director; interview, hire, and review team members
- Implement audits of team’s efficiency and throughness when working outstanding AR accounts
- Produce and maintain key performance metrics such as Charges, Payments, Days in AR, cash collections, etc.
- Oversees the management of select revenue cycle personnel. Trains, orients and evaluates
- performance of assigned personnel, recommends merit increases & structured bonus calculation,
- promotions and disciplinary actions.
- Establish with Director policies for the account receivable department
- Develops work standards, monitors quality and quantity of work processed, and ensures that policies are communicated and administered consistently to meet departmental goals. Works closely with coding and regional operation managers to monitor compliance to policies and procedures as they relate to the revenue cycle.
- Ability to motivate and engage team members
Required knowledge, skills and ability:
Technical service skills:
- Ability to recommend new approaches, policies, and procedures to influence continuous improvements in department’s efficiency and services
- Ability to conduct root cause analyses to identify areas where the process may not be working effectively or efficiently. Working with the Revenue Cycle Director, facilitates and manages process improvement efforts in the entities to drive improvement in the overall revenue cycle process.
- Ability to create and approve training manuals, policies and procedures, and job aids
- for Revenue Cycle areas.
- Ability to represent the Department in a professional manner when interacting with patients, guests,
- physicians and their staff
- Ability to handle service issues professionally
- Ability to follow through with customers
- Ability to communicate effectively to patients about their medical conditions and the financial aspects of their care.
- Ability to communicate effectively to patients, centers, and staff regarding departmental policy
- Maintains effective, consistent communication with Revenue Cycle team. Identifies and facilitates the resolution of issues that arise and impact markets
- Ability to type proficiently
- Ability to function effectively as extension of the Center
- Be flexible and open-minded in thought processes
- Maintain focus under pressure
- Share relevant information with other team members
- Ability to understand basic medical terminology
- Ability to calculate deductible and co-insurance correctly
- Ability to read and understand carrier Explanation of Benefits
Note: this job description is not inclusive of all the duties of the position. You may be asked by leaders to perform other duties. Management reserves the right to revise this position description at any time.
GoHealth provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. We invite military veterans to apply for our positions. In addition to federal law requirements, GoHealth complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
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GoHealth Urgent Care has outstanding career opportunities in Connecticut, Missouri, New York City, North Carolina, Northwest Arkansas, Oklahoma City, San Francisco and the Portland-Vancouver area. And all of these positions have one thing in common: flexibility to practice urgent care medicine the way it was meant to be, without the stress and bureaucracy of hierarchical organizations. With reasonable work hours that don’t emotionally exhaust them or burn them out, our team can balance and prioritize their professional and personal lives.
The lifestyle you can lead.
Atlanta is Georgia’s state capital and home to approximately half a million residents. Well known for its arts, theater, galleries and museums, cultural attractions, and institutions of higher education, Atlanta offers many things to do. Visit Georgia Aquarium, the largest public aquarium in the Western Hemisphere. Shop and enjoy great entertainment in Underground Atlanta. See wildlife shows at Zoo Atlanta. Catch a pro football, basketball or baseball game. Foodies will delight in local favorites, such as crab fritters, chicken biscuits, pulled pork sandwiches and salted caramel ice cream. Choose from many welcoming neighborhoods to live in, from downtown and midtown to Chastain Park, and from Buckhead to Cabbagetown, Kirkwood and Morningside. There’s also a good selection of public and private schools and nearby colleges and universities. Public transportation is excellent, and Atlanta is also served by Amtrak and Hartsfield-Jackson Atlanta International Airport.