Revenue Cycle Manager

Description

Blue Stone Therapy is certified as a Great Place to Work!

Blue Stone Therapy was founded in 2009 and provides contract physical therapy, occupational therapy, and speech-language pathology to communities in Iowa, Minnesota, Missouri, Nebraska, North Dakota, and South Dakota. Our focus is to deliver optimal, individualized rehabilitation by highly skilled professional therapists while developing long-term partnerships between our staff and the communities they serve.

We are seeking a highly motivated and detail-oriented Revenue Cycle Manager to join our team. The Revenue Cycle Manager is responsible for leading and managing billing operations including timely claim filing, insurance claim follow-up, charge posting, reimbursement, and insurance overpayments in a manner that is compliant with governmental and payor-specific billing requirements and regulations.

Essential Key Job Responsibilities

• Manages the billing process; maintain supporting documentation files and ensure proper handling and storage of files.
• Maintain ongoing que of denied claims review and responses. Research pending 30/45/60-day insurance claims daily. Researches and resolves 90+ day insurance claims monthly.
• Reviews, designs, and implements processes surrounding billing, third party payor relationships/reimbursements, compliance, collections, and other financial analyses to ensure effectiveness and proper utilization.
• Tracks and reports metrics regularly related to the client engagement cycle including session coding error rates, clean claim submission rates, denial rates/reasons, net collection percentages, systemic setup issues and billing turnaround times to develop sound revenue cycle analysis and reporting.
• Maintain comprehensive knowledge of all contracted insurance plans and fee schedules including remaining current with fees and reimbursement changes as they relate to contractual agreements.
• Coordinate all financial clearance activities by navigating all referral, precertification, and/or authorization requirements as outlined in payor-specific guidelines and regulations.
• Responsible for a variety of payment processes including, transferring payments across transaction, accounts, and data bases, overseeing balancing of payments posted to the accounts receivable system, entering and tracking returned checks, and processing payments.
• Maintain current knowledge of all Federal, State, and compliance regulatory requirements related to billing and insurance.
• Identifies trends, pursues inconsistencies and/or inaccuracies in coding and/or billing and proposes solutions.
• Other duties as assigned.
  
  

Requirements

Education and Experience

• Minimum of five (5) years of experience in a medical billing or revenue cycle role.
  
  

Knowledge, Skills, And Abilities

• Knowledge of insurance claims processing, third-party reimbursement principles, and concepts.
• Knowledge of CPT, ICD-9/ICD-10, HCPCS coding, billing, and medical terminology.
• Knowledge of Medicare, OIG, HIPAA, State & Federal statutes, and regulations.
• Proficiency in Excel, Word, and Outlook.
• Exceptional collaboration and customer relationship skills.
• Adapt easily to change in job duties and work environment.
• Excellent time management skills with a proven ability to meet deadlines.
• Net Health/Optima experience preferred.
  
  

Blue Stone Therapy is an Equal Opportunity Employer