Revenue Cycle Solutions Manager

The position of RCM Solutions Manager is essential to ensuring the execution of billing configuration and automation strategy goals.  This individual will ensure the operational direction and technical expertise needed to execute all RCM billing system solutions projects is provided. This individual is expected to work across departments to integrate RCM knowledge and expertise.

PRIMARY RESPONSIBILITIES

• Lead and Manage RCM System Solutions related to process improvement, redesign processes.

• Serves as a source of knowledge and performs analysis for performance improvement.

• Lead the Collaboration and coordination with other departments impacting revenue cycle billing system solutions

• Help identify areas of monetary loss in the revenue cycle process

• Work with various teams to help keep drive them towards the goal of reducing loss in the revenue cycle process

• Keep track of progress made by teams in fixing areas of loss towards the goal of achieving higher revenue

• Ownership for tracking overall progress with status reports to leadership

• Tracks outcomes of billing system payment resolution, appeals, and negotiated claims 

• Implement appropriate technology solutions to support continued improved cash collection performance. 

• Manage projects and initiatives for improved reimbursement and reporting on actual performance against these targets; continue to monitor performance for process control. 

• Meets established deadlines timely, accurately, and with a sense of urgency.

• This role works with PHI on a regular basis both in paper and electronic form and has access to various technologies to access PHI (paper and electronic) to perform the job

• Employee must complete training relating to HIPAA/PHI, privacy, General Policies and

• Procedure Compliance training and security training as soon as possible but not later than the first 30 days of hire.

• Must maintain a current status on Natera training requirements.

• Performs other duties as assigned.

QUALIFICATIONS

• Bachelor’s degree in Biology (Engineering) or equivalent.  MS or PhD in Biological Sciences preferred.

• Certifications in System administration and Systems Engineering or other certifications are a plus

• Minimum of 12 years of in revenue cycle, information systems, health insurance or healthcare billing Genetic testing  or laboratory diagnostic experience, a plus. 

• Knowledge of configuring and setting up hardware and software

• Demonstrated ability to learn new systems and software applications.

KNOWLEDGE, SKILLS, AND ABILITIES

• The role will require interaction with a wide range of fellow employees, senior leaders, as well as external auditors and experts, so a high standard of discipline and professionalism is required.

• Ability to think creatively and initiate new ideas or solutions to business issues. 

• Independence of thought and sound judgment relating to business needs. 

• Demonstrated commitment, self & team motivation, and drive.

• Act as an agent of change, positive influence, while maintaining appropriate level of independence.

• Ability to work in a fast-past, competing deadline driven environment.

• Advanced proficiency with quantitative software programs (Microsoft Excel, Google Sheets).

• Excellent SQL skills with experience in writing complex queries.

• Experiences in Snowflake preferred.

• Experience with BI tools such as Power BI or Tableau.

• Ability to define problems, collect and reconcile data, validate data against source information.

• Experience in Python statistical programming preferred.

• Motivated, shows initiative, and ability to work in a fast paced environment.

• Possess strong interpersonal skills and the ability to sell the business reason for the change.

• Drive for Results (Service, Quality, and Continuous Improvement).

• Commitment to the successful achievement of team and organizational goals.

• Demonstrate a focus on listening to and understanding client/customer needs and then delighting the client/customer by exceeding service and quality expectations.

• Excellent communication and soft skills

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