Revenue Cycle Manager

For over 55 years, We have been considered one of the innovative world leaders in the enhancement and improvement of care for foot and ankle medical conditions, sports medicine and clinical programs. Our mission is to improve the quality of life in a patient focused environment by providing the most advanced and knowledgeable foot and ankle care. WFAI has experienced phenomenal development, with expansion into 5 states and a future dedicated to continue with that growth strategy. As our family expands, we stand by our core values, which include: integrity, excellence, trust, caring, tradition and innovation.

POSITION SUMMARY

Develops and implements improvements to the facility's billing and collections activities and ensures revenue cycle compliance. This position is responsible for communication with clinicians and RCM team on a regular basis. This position may also require light travel on occasion. 

DUTIES AND RESPONSIBILITIES

• Provides direction to the RCM team regarding billing operations, billing and collection, coding and compliance, reimbursement and third-party contract compliance, and reporting.
•  Coordinates with employees responsible for charge capture or entry, coding, reimbursement, or insurance verification to identify and resolve issues impacting billing or collections. 
• Identifies causes of non-compliance or account/payment delinquency. Analyzes trends in under/overpayment, payment denial, or appeals and develops process improvements meant to improve operations and reduce costs. 
•  Ensures compliance with all relevant reporting and data collection regulations.
•  Provides training and education relative to regulatory and billing requirements.
•  Tracks metrics to develop and implement strategies for improvement.
• Manages the policies, objectives, and initiatives of RCM activities to meet target operational and revenue goals.

 QUALIFICATIONS/ EDUCATION/ CRITICAL SKILLS 

• A High School Diploma or equivalent.
• Podiatry experience preferred.
• Certified Professional Coder (CPC) a plus but not required.
• Minimum of 5 years’ experience interpreting insurance explanation of benefits.
• Minimum of 3 years’ experience with medical claims, billing, payment posting and insurance collections.
• §Knowledge of all insurance guidelines especially Medicare and Medicaid according to standards.
• §Knowledge of legal, regulatory, and policy compliance issues related to medical coding and 
• billing procedures and documentation.
• Experience with prior authorizations, pre-determinations, and out-of-network gap exceptions.
• Ability to supervise and mentor others.
• Ability to use independent judgment and to manage and impart confidential information.
• Must communicate logically and clearly both orally and in writing.
• Must be able to traverse the different practices.
• Legal eligibility to work in the United States without sponsorship now or in the future.
• Ability to successfully pass a background investigation / pre-employment screening, including a valid Driver’s License and clean DMV record with proof of insurance is required.

Benefits:

• Competitive salary and benefit program with a base salary (depending on applicable experience)
• Benefit eligibility for FT employees working 30+ hours weekly begins first of the month following 30 days of employment
• Eligibility to participate in our 401(k) program begins first of the month following 60 days of employment
• Medical, Dental, and Vision Plans 
• HSA with Employer Contribution 
• FSA Option
• Generous PTO Program 
• Employee Assistance Program
• Life and AD&D Insurance 
• Short-Term and Long-Term Disability  

PHYSICAL DEMANDS/ ENVIRONMENTAL FACTORS:

This job description is not designed to cover or contain a comprehensive listing of duties or responsibilities that are required of the employee. Weil Foot & Ankle Institute is proud to be an affirmative action employer and we are committed to an equal opportunity workplace, regardless of race, color, religion, sex, sexual orientation, ender identity, ancestry, citizenship, national origin, marital status, veteran status or disability. If you have a disability or special need that requires accommodation, please let us know.

• While performing the duties of this job, the employee is regularly required to stand or sit; use hands; and talk or hear
• Specific vision abilities required by this job include close vision, distance vision and depth perception

AMERICAN WITH DISABILITIES ACT (ADA) SPECIFICATIONS:

Qualified individuals with disabilities may make a request for reasonable accommodation to the Director of Human Resources.  Upon receipt of an accommodation request, the Director of Human Resources will meet with the requesting individual to discuss and identify the precise limitations resulting from the disability and the potential accommodation that might help overcome those limitations. The Director of Human Resources in conjunction with a medical review (and, if necessary, other appropriate management representatives) will determine the feasibility of the requested accommodation and the impact on the business operation.  The Director of Human Resources will inform the qualified individual of the decision of the accommodation request or how to make the accommodation.