Operations Manager | Healthcare Account | RCM | On Site

3 weeks ago

Pasig City, Philippines Microsourcing Philippines Inc Full time
With over 8,000 professionals across 9 delivery centers in the Philippines, MicroSourcing remains the country's largest offshoring solutions provider.
  
Revenue Cycle Manager, be 100% YOU with MicroSourcing
  
Position Summary:
  
The Revenue Cycle Manager will be responsible in overseeing the areas of medical coding, billing and insurance-related processes (claims, appeals, denials, eligibility and benefits etc.)
  
A Revenue Cycle Manager is expected to:

The Revenue Cycle Manager will be responsible for the following FTEs:
Insurance Accounts Receivable Representatives
-  These representatives are responsible in providing the highest quality of customer service and accounts receivable management to our patients by embracing the WellCare Guiding Principles.

Certified Professional Coders
-  These professionals are responsible to abstract and identify the correct CPT and ICD-10 codes from various encounter forms and medical reports and file claims to insurance providers for timely and accurate reimbursement.

Payment Posting Representatives
- These representatives are responsible to outline the expectations for all employees or contractors who receive cash payments, check payments, or electronic remittance advice (ERA's) payments that should be posted to the AR, General Ledger, or any other source that may require payment posting receipt(s).

Eligibility and Benefits Representatives
- These representatives are responsible in verifying all scheduled appointment/patient's insurance coverage. the verification process includes provider credentialing with the health plan, checking of eligibility status, effective date, other health insurance or coordination of benefits, patient cost share responsibility (co-pays, co-ins or deductibles).

What it takes to be part of our team:
Must have at least 5 years of managerial/supervisory experience in managing a healthcare account.
Bachelor's Degree in any field.
Must have a background and understanding of medical billing process
Knowledge in using ERA (Electronic Remittance Advice), Lock Box and EFT (Electronic Fund Transfer).
Ability to understand logic of standard medical coding guidelines (ICD-10-CM, CPT, HCPCS codes, etc.)
Background knowledge of Medicare, Medicaid, and Commercial Insurance procedures.
Excellent oral and written communication skills with ability to communicate effectively with physicians, insurance providers, patients and external vendors.
High level of accuracy and attention to detail.
Excellent organization and planning skills, collaboration and partnering skills.
Ability to maintain confidentiality and adhere to ethical standards which includes knowledge of HIPAA Law.
Ability to multi-task and make sound decisions and critical judgement quickly in a fluid work environment
Proficient in using Microsoft Office Applications esp. in creating reports and presentations
Amenable to work on Night Shift Schedule
Amenable to Work On-Site (Ortigas Site)

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