Lead Revenue Cycle Management

Company: Total Vision

Position: Lead Revenue Cycle Management

Location: Total Vision Support Center 27271 Las Ramblas Suite 210 Mission Viejo CA 9269

Duration: Fulltime Direct Hire

Pay: $22.00 to $28.00 per hour

Total Vision is a group of highly successful optometry practices that have aligned towards a common goal of worldclass eyecare results for its patients and California communities. We are a company that is seeing significant growth and are looking for topnotch team members with the passion energy focus and commitment to excel in this type of environment.

Job Description

This position will handle and resolve escalated billing issues. They will analyze reports and identify trends areas of improvement and training opportunities.

Duties/Responsibilities:

• Identifies billing and denial trends and communicates them regularly with Manager/Supervisor.
• Coordinates with Manager/Supervisor to ensure department deadlines are met.
• Spot checks completed assignments to confirm accounts are being handled properly providing regular feedback to Manager/Supervisor.
• Resolves escalated billing issues in a prompt manner.
• Provides training to team members.
• Partners in the development of new SOPs.
• Recommends ongoing improvements to processes and procedures.
• Reviews and processes patient statements for multiple locations.
• Process refund requests and post refunds into the system.
• Reads and interprets insurance Explanations of Payments (EOP) or Explanations of Benefits (EOB) with understanding and can independently take appropriate next steps to resolve issues.
• Posts payments charge backs adjustments and remark codes in a timely and accurate manner.
• Research difficult ERAs/EOBs.
• Research open accounts receivables resolves claims errors and reprocesses claims for successful payment.
• Maintains integrity of patient ledgers following guidelines provided to manage balances.
• Submits claims electronically and by paper as required. This includes sending secondary claims with attached explanation of benefits.
• Demonstrates a high level of competency and business rapport with clinic teammates providing timely feedback on billing and coding changes and obtaining pertinent information to drive timely claims submissions. Advocates for coding accuracy and compliance with federal state and local rules and regulations.
• Ensures compliance with all HIPAA/HITECH requirements as legally required and all applicable federal state and local regulations.
• Other duties as assigned.

Qualifications

• Required Skills/Abilities:
  • Has excellent customer service skills.
  • Presents professionally and communicates clearly accurately providing instructions to team members and feedback to leadership.
  • Embraces and aims for a paperless work environment.
  • Demonstrates ability to solve problems and work as a positive member of a team.
  • Is technology savvy and appreciates finding new ways to make processes easier.
  • Can stay focused on projects and can multitask when needed.
  • Brings his/her best self to work everyday and can contribute positively to a team environment.
  • Desires a longterm growth opportunity.

Education/Experience:

• Healthcare billing or collections experience: 3 years (optometry preferred but not required)
• Strong typing and data entry skills including 10key
• Strong knowledge of Microsoft products including: Excel Word and Outlook
• Leadership experience

Optometry,Retail,Medical Billing,Revenue Cycle Management