Rcm Leader

Revenue Cycle Leader
Montreal, Quebec, Canada

Do you have strong expertise in revenue cycle management for United States medical practices? Do you like to wear many hats and make an impact? We’re recruiting an onsite revenue cycle leader to manage all functions of a start-up organization’s medical billing and revenue cycle to maximize cash flow while maintaining and improving internal and external health plan/payer relations. The leader will contribute to the day-to-day operations on all issues related to the revenue cycle function, provide analysis, create written processes, and train others in implementing a cross-functional revenue cycle team.

EDUCATION AND EXPERIENCE
Bachelor’s degree in business, healthcare administration, or equivalent.
At least 5 years of United States medical billing experience.
Command of revenue cycle management principles, including working knowledge of cash posting processes, medical record guidelines, coding, and accounts receivable follow-up (e.g., HCPCS, CPT, ICD codes).
Experience with the provider payer credentialing process.
Experience working with big commercial payers.
Demonstrated coding and billing knowledge/experience preferred.
Manager/supervisory experience is a big plus.
Experience evaluating and transitioning systems and/or managing systems for growth.
Proven track record with other start-ups or venture capital-funded companies a plus but not required.

ESSENTIAL SKILLS AND ABILITIES
The ability to coordinate and negotiate rates and contracts on behalf of the organization with commercial payers.
Excellent organizational skills, communication skills, and the desire and ability to learn and move quickly.
Knowledge of professional fee billing, reimbursement, third-party payer regulation, and medical terminology is required.
Working knowledge of regulatory requirements pertaining to health care operations and their impact on operations.
Change management skills to identify and implement process improvements.
Strong problem-solving skills and the ability to make timely decisions.
Strong attention to detail.

RESPONSIBILITIES
Manage the Full Cycle Revenue Cycle Management team and process.
Collaborate with the Product/Engineering team on product issues impacting billing.
Oversee the weekly billing processes and ensure accurate billing of insurance providers and patients.
Document medical billing denials from insurance providers.
Evaluate billing processes and procedures.
Ensure correct coding (both procedural and diagnostic) for services and adjust as necessary.
Follow up on claims.
Work with patients to resolve issues in a timely manner.
Work claim denials, including initiating the denial appeal process and documenting and tracking the status of appeals.
Resolve issues with billing and payment on patient accounts.
Be a resource to answer patient and staff questions on billing, charges, and insurance eligibility.
Train new and current staff on accurate and complete patient registration; work with providers to coach them on best coding practices.
Follow up with patients and insurance companies about outstanding invoices.