Manager, Accounts Receivable

The RCM A/R Manager is vital to ensuring that all services billed to insurers are collected promptly and posted correctly to patient accounts. Equally vital is the RCM Manager’s ability to analyze data to prioritize work and to identify and resolve the root causes of claims that deny or do not pay correctly. This position is responsible for organizing, integrating, and leading onshore and offshore A/R follow-up and payment posting teams for all types of claims - whether in-network or out-of-network, government or commercial, electronic or paper - for all EMRs supported by Panoramic Health. The RCM A/R Manager is responsible for knowing related regulations and payer rules, creating and refining related policies, workflows, procedures, and SOPs to ensure effective and efficient collections and payment posting.

Responsibilitiesinclude:

• Develop workflows, policies, procedures, and SOPs for the functions of A/R follow-up (i.e. all “Back-end” RCM functions).
• Analyze claims data to reprioritize resources as needed to resolve claims denials and payments requiring manual intervention to post correctly.
• Effectively integrate and manage resources - AthenaOne/other EMRs, Onshore, Offshore, and Practice Partners to collect reimbursements due effectively and efficiently, maintaining an A/R >90 days as defined by organizational leadership.
• Quickly identify trends and resolve the root causes of claims denials and working with RCM  “front-end” resources to maintain a Clean Claims First Pass Rate as defined by organizational leadership.
• Report RCM performance to RCM leadership and, as authorized by an RCM Director, work with others as appropriate to provide transparency to Panoramic Practices, including performance metrics and action plans where performance is not meeting targets.
• Maintain confidential patient, employee, and company information in compliance with company policies and procedures, HIPAA, and other regulatory requirements.
• Implement and manage Payment Posting and Bank Reconciliation functions that resolve “Unpostables” within 5 days of receipt from AthenaOne or other EMR systems supported by Panoramic Health.
• Ensure all transactions in queues or worklists related to RCM “Back-end” functions are staffed, monitored, and resolved effectively within an average of 2.5 touches.
• Oversee the correct adjustment of claims per payer EOBs and Panoramic Health Policies and Procedures. Resolve incorrect adjustments within 30 days.
• Implement and oversee Quality Control efforts to ensure claims are worked correctly, efficiently, and according to payer rules, regulations, and Panoramic policies and procedures.
• Achieve all training requirements of AthenaOne and other systems at the level of RCM Manager and provide training and guidance to RCM A/R staff members, assisting as appropriate in developing their skills and capabilities.
• Prepare required reports, budgets, performance reviews, and other requirements of RCM and Panoramic leadership in a timely and effective manner.
• Provide leadership, coaching, and development of onshore and offshore staff. Help them deliver the required performance while achieving a turnover rate of less than 20% per year.
• Serve as a subject matter expert (SME) by maintaining current knowledge of local, state, federal regulations and payer rules.
• Establish and maintain effective working relationships with cross-divisional teams, management, vendors, consultants to ensure the effective resolution of issues and optimize Panoramic Health performance and value.
• Perform other duties and responsibilities as required, assigned, or requested

Qualifications:

• College degree or equivalent related work experience
• High school diploma or equivalent required
• 5 years of related experience
• Expertise in AthenaOne, AdvancedMD, and EPIC and other systems supported by Panoramic Health RCM
• Strong computer skills and expertise in Excel, Word, PowerPoint, Visio, and other applications
• Detailed knowledge of the RCM A/R and an ability to demonstrate performance success
• Detailed knowledge of Payment Posting for physician enterprises
• Knowledge of Physician Practice EMRs, specifically AthenaOne, AdvancedMD, EPIC or similar systems
  • Ability to learn and manage new systems as groups are integrated into Panoramic Health
  • Ability to make recommendations for EMR improvements to improve automation, quality, or performance of the EMR
• Time management, organizational, follow-up skills capable of performing in a fast growing, challenging environment
• Creative problem solver who meets performance targets while making work fun and rewarding for staff
• Excellent oral and written communication skills