Revenue Cycle Manager in Etters at Rite Aid

Date Posted: 12/4/2019

Job Snapshot

Job Description

Job Description

SUMMARY

 

The primary purpose of this job ensures the financial integrity and Accounts Receivable by performing established financial processes that enable and expedite the billing and collection of medical services. This includes: creating claims according to regulations and compliance guidelines, patient account research and resolution, insurance verification and benefit determinations, identification of reimbursement issues, resolution of credits and issuance of refunds, identification of payment variance invoices, follow up and resolution of denied claims. Responsible for working correspondence denials and insurance follow up. This must be done in a timely and accurate manner, in accordance with provided work instructions by performing the following duties.

 

ESSENTIAL DUTIES AND RESPONSIBILITIES

  • Lead the medical revenue cycle team (for Pharmacy and Clinics) and collection for all patient encounters from claims submission through collection to manage accounts receivable to maximize revenue collected.
  • Direct staff to ensure that accurate submission of all claims and timely collections occur in accordance with all third party contracts terms including, Medicaid, Medicare, managed care, commercial insurance, and direct patient pay.
  • Ensure that unprocessed claims and deials are reviewed, reworked, and resubmitted to ensure revenue maximization.
  • Assure maximization of cash collections through diligent and timely monitoring of all open accounts receivable balances.
  • Review performance statistics weekly, monthly, and quarterly, including overall performance metrics (e.g. DAR, practice collections), key driver metrics (e.g. denials, Manager Holds), and staff productivity metrics (e.g. Unpostables, missing slips).


Experience / Requirements

  • 5 years of experience in of medical claim experience preferably in both medical AND pharmacy claims required
  • 3 years of experience in Supervisory Experience required.


Education

  • Bachelor’s Degree in Arts/Sciences (BA/BS)
  • OR Bachelor’s Degree in Finance, Accounting, Business, Healthcare Administration or equivalent required