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Supervisor, Revenue Cycle Systems
Location
Wisconsin
Posted
3 days ago
Salary
$76.4K - $114.6K / year
Seniority
Senior
Job Description
Supervisor, Revenue Cycle Systems
Exact Sciences
• Manage the day-to-day operations of the Exact Sciences Laboratories Systems team. • Provide supervision, hiring, training, and coaching, managing workloads, and handling escalated concerns as related to revenue cycle systems and analytics. • Maintain accurate data reporting and be responsible for metrics and productivity measures, as well as any other key performance indicators. • Facilitate contract implementation and revenue pull-through activities, both proactive and reactive, with internal and external parties as needed. • Ensure billing and payment processes are efficient, timely, and in compliance with corporate goals, contracts and/or regulations. • Coach, mentor, and engage team members to increase overall performance. • Assist in identification and reporting of system errors and workflow solutions. • Oversee the creation and maintenance of payor and client master files to ensure accurate and timely updates or changes. • Investigate and resolve electronic remittance errors. • Drive operational excellence of order entry and exception handling processes; including process flow, data integrity, information alignment, and continual process improvement. • Support and Lead cross-functional initiatives across multiple departments. • Act as a liaison between other functional areas within Exact Sciences Laboratories. • Collaborate with team leadership and support the day-to-day team operations. • Lead the development and maintenance of a contract database and contract management system, working with the credentialing and legal teams. • Collaborate with finance and analytics to identify, analyze, and determine next steps to address negative revenue pull-through scenarios specific to payers and across payer segments, including Medicare Advantage, Blues, Medicaid, etc. • Collaborate with RCT Managers to develop and leverage relationships with billing operations staff and payers when resolving claim adjudication issues, both contractual and non-contractual. • Support execution of pull-through plans to meet quarterly revenue goals. • Facilitate conversations with appropriate Exact personnel early in the contracting process to provide an overview of the account to avoid delay in implementation down the road. • Report and suggest system changes to Revenue Cycle Leadership and Revenue Cycle staff as needed. • Work closely with vendor and payor partners to identify and resolve systematic issues. • Provide systematic support to ensure timely electronic submission of claims, including subscriber ID format, Z-code requirements, etc., based on payor and contractual requirements. • Work directly with Client Support and Implementation Services (CSIS) teams to ensure accurate and timely client implementations as concerns the revenue cycle. • Develop and oversee processes and procedures for the efficient and successful flow of interdependent information between the third-party billing vendor, the receivables department, and Exact Sciences’ contact center. • Assist in the oversight of maintenance and updates regarding software vendor changes. • Provide escalation support to staff. • Take part in the creation of training and Standard Operating Procedures (SOP) materials as appropriate; identify additional training needs/resources as needed. • Provide guidance on priorities for the department; ensure work is completed in a timely and accurate manner. • Assist with recruiting, hiring, onboarding, coaching, and counseling of department staff. • Supervise staff; including, but not limited to, organize and prioritize work, write/conduct performance reviews, train/develop, and manage work performance. • Communicate goals clearly to employees to ensure understanding and success in achieving them. • Ensure that appropriate training opportunities are identified and provided to employees to grow personal, career, and organizational development capabilities. • Promote a team-oriented environment that fosters effective collaboration within and outside of the department. • Provide on-going coaching to staff to ensure a consistent level of service is maintained.
Job Requirements
- Bachelor’s degree in Information Systems, Finance, Business, or related field; or High School Degree/General Education Diploma and 4 years of relevant experience in lieu of Bachelor’s degree.
- 3+ years of experience in the medical revenue cycle function to include third party payer experience.
- 3+ years of experience working in the medical/healthcare billing area; with strong, demonstrated knowledge of Epic Resolute systems.
- 3+ years of experience working with a third-party billing service provider or revenue cycle management software.
- 2+ years of experience in a position with responsibility leading direct reports, including leadership roles.
- 5+ years of experience working in a customer service environment specialized in providing an exceptional customer experience.
- Demonstrated knowledge of medical coding including International Classification of Diseases (ICD-9) and (ICD-10) and Coding Procedure Terminology (CPT) and HCPCS coding.
- Demonstrated knowledge of Explanation of Benefits (EOB); must be able to read and interpret explanation of benefits (EOB) for all payers.
- Demonstrated understanding of ASC X12 (ANSI) claims adjustment and remark codes.
- Knowledge and familiarization with Medicare billing regulations and reimbursement methodologies.
- Authorization to work in the United States without sponsorship.
- Demonstrated understanding of content development, facilitation, and evaluation of training.
- Demonstrated understanding of working in customer service, billing, data entry, or healthcare related field.
- Demonstrated ability to plan workload, allocate tasks, and scale operations to align with business priorities.
- Strong computer skills to include internet navigation, use of virtual meeting/facilitation platforms, use of messaging services, and use of Microsoft Office programs.
- Demonstrated ability to perform the Essential Duties of the position with or without accommodation.
- Must maintain all certification requirements as deemed necessary.
Benefits
- paid time off (including days for vacation, holidays, volunteering, and personal time)
- paid leave for parents and caregivers
- retirement savings plan
- wellness support
- health benefits including medical, prescription drug, dental, and vision coverage
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