Role Description Remote Hours: Monday - Friday, 8:00 AM - 4:30 PM EST (or based on business needs) What Revenue Cycle Management (RCM) contributes to Cardinal Health: - Manages a team focused on clinical and administrative processes for capturing, billing, and collecting patient service revenue. - Shadows the entire patient care journey from appointment scheduling to account balance resolution. Responsibilities: - Provides ongoing support to the team to ensure that day-to-day service and production goals are met. - Assists management in monitoring associates’ goals and objectives daily; motivates and encourages associates to maximize performance. - Provides ongoing feedback, recommendations, and training as appropriate. - Assists supervisors in ensuring staff adherence to company policy and procedures. - Acts as a subject matter expert in claims processing. - Investigates insurance claims; properly resolves by follow-up & disposition. - Leads and manages invoicing projects, addressing complex issues and ensuring timely resolution to maintain optimal account receivables performance and client satisfaction. - Resolves complex invoicing complaints, including member call back and agent co, to ensure timely and accurate reimbursement. - Verifies patient eligibility with secondary insurance company when necessary. - Bills supplemental insurances including all Medicaid states on paper and online. - Manages invoicing queue as assigned in the appropriate system. - Investigates and updates the system with all information received from members. - Ensures that all information given by representatives is accurate by cross-referencing with the patient's account. - Updates patient files for insurance information, Medicare status, and other changes as necessary or required as related to billing. - Maintains accurate and detailed notes in the company system. - Leads the outsourced team, providing guidance, answering questions, and ensuring high-quality customer service related to patient invoicing. - Serves as the primary contact for outsourced team members, resolving any issues or concerns that arise in the invoicing process. - Ensures that outsourced team members are trained in company policies, procedures, and systems related to invoicing and customer service. - Monitors the performance of the outsourced team, providing feedback and support to help them achieve their goals and improve their skills. - Collaborates with the outsourced team to identify and implement process improvements that enhance efficiency and customer satisfaction. - Adapts quickly to frequent process changes and improvements. - Is reliable, engaged, and provides feedback to improve processes and policies. - Attends all department, team, and company meetings as required. - Appropriately routes incoming calls when necessary. - Meets company quality standards. Qualifications - High School diploma or equivalent. - 3 years’ experience with insurance billing and processing claims preferred. - 3 years’ experience with Medicare claims, and Medicare and private insurance verification preferred. - Knowledge of insurance portals; familiarity with a variety of medical and/or insurance terms or practices. - Full knowledge of all areas of collections specialization preferred. - Proficiency in basic math and business calculations. - Working knowledge of computer/data entry with the ability to learn new systems. - Basic level of MS Office proficiency. Requirements - Friendly, professional, and effective communication skills; able to calmly present solutions in challenging situations. - Proactive identification of challenges, and solution-oriented approach to problem solving. - Service-orientation and aptitude to resolve insurance and/or patient matters. - Effective analytical skills: able to use inductive and deductive reasoning to anticipate outcomes. - Self-directed accountability and reliability. - Effective communication and interpersonal skills, with the ability to influence and collaborate effectively with cross-functional teams. - Cross-trained on all collections processes. - Able to resolve highly escalated collections issues or concerns. - Able to mentor and train as needed. - Able to manage and prioritize multiple tasks/projects, work autonomously, and meet deadlines. - Able to work well in a team environment that promotes inclusiveness and communication among team members. - Communication using both verbal and written English proficiency. - Cultural competence. Benefits - Medical, dental and vision coverage. - Paid time off plan. - Health savings account (HSA). - 401k savings plan. - Access to wages before payday with myFlexPay. - Flexible spending accounts (FSAs). - Short- and long-term disability coverage. - Work-Life resources. - Paid parental leave. - Healthy lifestyle programs.