RCM Supervisor

Job Details Job Location: Congress Billing LLC - Delray Beach, FL 33445 Position Type: Full Time Salary Range: $60,000.00 - $75,000.00 / year Travel Percentage: Negligible Shift: Day (First Shift) Position Purpose The purpose of the RCM (Revenue Cycle Management) Supervisor position is to oversee and manage the revenue cycle functions within a healthcare organization. The RCM Supervisor is responsible for ensuring the proper identification, collection, and management of revenues from patient services. They play a crucial role in unifying the business and clinical aspects of healthcare by coupling administrative data with the treatment a patient receives. Qualifications Education: Minimum of High School Diploma or Equivalent. Preferably a Bachelor’s degree in business or a related field. Experience: Minimum of three years progressive related experience or equivalent combination of education and experience. Minimum of 3 years of management experience within a hospital or medical billing company setting. Proven knowledge of Rev, CPT and ICD-10 CM coding (medical, mental health and substance abuse preferred). Integral knowledge of the A/R process and proven managerial success in analyzing A/R reports. Licensure/Certification: Current CPR certification. Knowledge & Training: Knowledge of the Principles and Practices of the discipline, Joint Commission Standards, state & federal statutes regarding client confidentiality laws, drug‑free workplace policies, workplace violence. Proficiency in communication & written skills. Strong computer skills with various EHR systems, comprehensive knowledge of revenue cycle business office practices, proficiency in Revenue Cycle Management Systems, Learning Management Systems, Microsoft Office, database and spreadsheet analysis, and presentation programs. Understanding of federal, state, and private payer regulations and applicable organizational policies and procedures. Responsibilities Maintain knowledge of the operational details of all positions in the Revenue Cycle Management process, including insurance claim submission, clearinghouse and payor claim rejections, payment posting, insurance claim denial management, verification of benefits, OON payer, underpayment repricing. Initiate modifications of all procedural paperwork related to accounts receivable-encounter forms, billing, verifications, etc. Meet with Billing and Collections staff monthly to analyze A/R reports, days in receivable, and collection statistics. Perform weekly billing audits to ensure timely and accurate processing of charge and payment posting. Conduct detailed audit of Explanation of Benefits forms from commercial and managed care payors at least biweekly; prepare or present results to Executive Management. Meet with Collections staff to discuss difficult claims and provide solutions. Train and oversee performance of Billing, Collections and Verification staff; assist with recruitment, discipline, and termination. Monitor overall workload in the department and distribute work accordingly, ensuring all posts are filled in case of vacation and sick days. Maintain fee schedule as well as CPT, ICD-10 CM, adjustment, payment, and payor files in the computer system. Maintain and distribute payment contracted schedules as received from contracted carriers, input/update schedule into the computer system. Request payment schedules from contract carriers as needed. Prepare fee/payment comparative report quarterly. Maintain carrier contract files and the Compliance Binder. Complete all credential applications and reapplications as requested. Seek and recommend ways to use technology to improve operational efficiency. Maintain patient confidentiality by following the HIPAA Compliance Plan established by the practice. Attend all meetings as requested and perform any additional duties as requested by Executive Management. Protect the privacy of all patient information in accordance with the company’s privacy policies, procedures and practices. Report any concerns regarding the company’s policies and procedures on patient privacy and any observed practices in violation of the policy to your supervisor without threat of retaliation. Perform other duties assigned. Individuals Served: Adult. #J-18808-Ljbffr Guardian Recovery Services