Laboratory Revenue Cycle Manager
- Expired: over a month ago. Applications are no longer accepted.
Lighthouse Lab Services is one of the leading providers of laboratory personnel in the country. Currently we are representing a clinical lab near Scranton, PA that is looking for a Revenue Cycle Manager to add to their team! The Revenue Manager will manage and coordinate the revenue cycle activities with the goal of providing strategic direction to maximize reimbursement, establishing and monitoring revenue cycle activities in a cost-effective manner, in compliance with federal and state laws, and payer-specific billing requirements.
- Captures and maintains current and accurate credentials and licensure information for clients
- Tracks document expiration and re-credentialing dates, CAQH status and advises of upcoming expirations
- Create and manage continual process and quality improvement efforts related to payer enrollment, data entry, credentialing committees and all aspects related to credentialing & enrollment.
- Consistently monitors payer credentialing status and advises of additional information required
- Provide strategic direction to PRMO in order to facilitate maximization of clinical revenue in a cost-effective manner.
- The Revenue Manger will proactively identify issues and opportunities for improvement as well as follow-up on department concerns.
- Review all KPI reports that would help identify trends, increase productivity and other improvements.
- Monitor financial targets, trends and develop action plans working with members of applicable teams to correct or improve any variances
- Conduct performance evaluations, assessing growth needs and project updates from assigned Revenue Manager(s) through appropriate opportunities.
- Provides primary source verification and facilitates background checks
- Maintains knowledge of payer credentialing requirements of insurances
- Assists with appeal letters
- Provides consultation/advisory services and support to clients and other departments
- Reviews payer contracts and assists with contract negotiation
- Complies with all local, state, and federal laws
- Maintains confidentiality of all client information
- Develops close working relationship with supervisor, other members of the credentialing team, and sales team
- This position requires knowledge of insurance processes and billing regulations and is responsible for fiscal oversight of accounts receivable functions
- Interfaces with third party payors to develop procedures and ensure timely payment of claims
- Assists the CFO/COO in development of rates for negotiation with third party payors
- Monitors agency compliance to Medicare and Medicaid reimbursement regulations
- Collaborates and coordinates with the annual audit as related to areas of responsibility
- 5+ years of experience in managed care credentialing, billing and/or medical setting, or Business background required
- 3+ years of management experience preferred
- Understanding of medical billing and coding
- Knowledge of healthcare industry, HIPAA regulations and insurance company policies
- Demonstrated skills in problem solving and analysis and resolution
- Must be able to function independently, possess demonstrated flexibility in multiple project management
Salary and Benefits:
-80k-100k (depending on experience)
-Full health benefits: medical, dental vision
At Lighthouse Lab Services, we offer solutions to help start, grow, and run clinical laboratories. Our recruiting team has over 19 years of proven success placing job seekers in positions ranging from entry-level Medical Technologists to seasoned Laboratory Directors. We recruit nationwide, for permanent and travel positions with clients ranging from small hospitals to large reference laboratories.
It is the policy of Lighthouse Lab Services to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state, or local law. In addition, Lighthouse Lab Services will provide reasonable accommodations for qualified individuals with disabilities.
Lighthouse Lab Services | 800-838-0602 | lighthouselabservices.com
Lighthouse Lab Services
Finance and Insurance
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