Polaris Healthcare -
Overview : We are in search of a highly skilled Revenue Cycle Manager with an exceptional understanding of Medicare, Medicaid, HMOs, and their respective contracts and plans.
The ideal candidate will work closely with the front office to ensure patients are in-network, collaborate with consultants to ensure all contracts are in place, and liaise with the billing team to ensure billing and collections processes are optimized.
Additionally, we seek someone with a strong desire to continuously learn and improve billing practices.
Responsibilities :
- Contract Expertise :
- Possess a deep understanding of Medicare, Medicaid, and various HMO contracts and plans.
- Collaborate with consultants to ensure all contracts are up-to-date and negotiated effectively.
- Stay informed about changes in regulations and reimbursement policies related to Medicare, Medicaid, and HMO contracts.
- Network Management :
- Work closely with the front office team to ensure patients are enrolled in in-network plans.
- Develop processes and protocols to verify insurance coverage and eligibility before appointments.
- Billing and Collections Oversight :
- Collaborate with the billing team to ensure accurate and timely claim submission.
- Monitor billing and collections processes to identify areas for improvement and efficiency.
- Training and Development :
- Provide training and support to the billing team to ensure they are equipped with the necessary skills and knowledge to navigate different contracts and plans.
- Foster a culture of continuous learning and professional development within the revenue cycle department.
- Quality Assurance :
- Conduct regular audits and reviews to ensure compliance with billing regulations and contract terms.
- Implement corrective actions to address billing errors and prevent claim denials
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