COMPANY: SHIELDS HEALTH CARE GROUPPOSITION: REVENUE CYCLE MANAGERLOCATION: BROCKTON, MA/QUINCY, MA Shields Health Care Group is a leading medical provider in New England. Our world-class team is made up of innovative thinkers and enthusiastic collaborators who take pride in delivering the highest quality service to patients and medical professionals across more than 40 locations. It s a great time to be a part of the Shields team as we grow and diversify our services beyond Medical Imaging and into the Ambulatory Surgery space. We take pride in our corporate culture by investing in our people and technology. We ve created an intellectually fulfilling work environment driven by our talented team, all collaborating to address the complex needs of our healthcare system. JOB ROLES/RESPONSIBILITIES: Manage the ASC Revenue Cycle team oSet goals and provide performance feedback, annual reviews, weekly payroll, management of PTO, and employee relations.oManage revenue cycle responsibilities, including but not limited to coding, billing, payment posting, denial management, collections and third party reimbursement mechanisms.oStreamline and optimize the revenue cycle workflow.oManage outsourced revenue cycle functions including but not limited to coding services. Utilize skills and knowledge to perform revenue cycle services for multispecialty ASCs oInitiate and maintain relationships with insurance provider representatives to facilitate payments of claims.oTrack payer trends, provide financial analysis, and monitor collection activity.oDevelop and maintain key performance indicators to track progress towards goalsoTrack statistics against regional and national benchmarks Ability to influence change and work collaboratively with groups at all levels inside and outside of the organization to develop an efficient process and achieve optimum resultsoEngage with Shields ASC onsite Administrators and Patient Access Representatives regarding patient scheduling, point of service collections, price estimation, eligibility verification, prior authorizations, and other front-end responsibilities that impact the revenue cycle function.oCollaborate with patient scheduling and clinical staff to ensure the understanding of new technology, and workflow processes that impact reimbursement. oFoster a positive relationship with multiple joint venture partners.oRegularly communicate with the Shields Provider Enrollment Team to reconcile contracts and payment expectations with payers. oIn conjunction with Shields IT, assist in development and improvement of systems including implementing EDI and ERA for all possible payers. Stay current on education and training oStay up-to-date on changes relative to ASC lobbying/legislative efforts.oMonitor billing protocol changes and fee schedule updates pertaining to device intensive codes, multiple procedure billing, bundled payments, Medicare, and MassHealth.oAttend coding and billing seminars.oRead payor contracts, understand payor notices, be aware of upcoming deadlines in contracts, reimbursement opportunity of implants or drugs and assist in payor negotiation.QUALIFICATIONS: Minimum 5 years of revenue cycle experience Team management experience Must have working knowledge of CPT and ICD codes. Ability to prioritize and complete tasks in a timely manner. Experience using a medical software billing system. Must be able to travel locally to visit locations/attend meetings/train individuals Surgical billing experience required/ASC billing experience prefered
EDUCATION: Bachelor s Degree required INTERNAL/EXTERNAL INTERACTIONS: Extensive interactions with all customer groups, including patients, families, referring community and SHC employees. NOTE: It is not intended that this Job Description include all details of the work functions of this position. The incumbent will perform work of a lower or equivalent classification as required or directed, and work of higher classification for training and development purposes or as situationally warranted
* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.