Psynergy Health

Position Overview

PsynergyHealth is a fast-growing telehealth platform dedicated to revolutionizing virtual care delivery.

We are seeking a highly analytical and compliance-driven Manager of Revenue Cycle Management (RCM) based in Florida to lead our end-to-end billing and reimbursement pipeline.

In this role, you will be responsible for the strategic oversight and daily operational execution of patient intake, medical coding, claims submission, denial management, and accounts receivable (A/R). As a hands-on leader and credentialed coding expert, you will ensure our telehealth billing practices align perfectly with rapidly evolving state and federal regulations. You will eliminate reimbursement bottlenecks, improve clean claim rates, and optimize cash flow, transforming our financial operations into a highly efficient engine that supports our clinical expansion.

Core Responsibilities

1. Billing Operations & Clean Claim Management

· Oversee the daily operations of the billing, coding, and collections teams to meet monthly financial goals.

· Monitor key performance indicators (KPIs) including Days Sales Outstanding (DSO), clean claim rates, and net collection rates.

· Supervise the complete claims lifecycle, ensuring accurate front-end demographic verification and rapid back-end payment posting.

· Audit and resolve high-dollar or complex claim denials, identifying root causes to implement permanent systemic fixes.

2. Regulatory Medical Coding & Auditing

· Act as the final internal authority on medical necessity, telehealth modifiers, and complex ICD-10-CM, CPT, and HCPCS coding structures.

· Perform regular, randomized documentation audits across clinical staff to ensure coding accuracy and compliance with payer policies.

· Train providers and clinical teams on accurate documentation practices to prevent downcoding and mitigate audit risks.

· Monitor industry shifts in CMS rules, commercial payer policies, and specific Florida Medicaid billing guidelines for telehealth.

3. Payer Relations & System Optimization

· Manage relationships with commercial insurance providers, Medicare, and Medicaid to resolve structural reimbursement issues.

· Serve as the internal operational liaison to the external RCM partner; participate in biweekly and monthly performance meetings to align internal workflows with vendor systems and collaborate on strategies for timely claim submissions.

· Partner with the IT and product teams to optimize the billing and clearinghouse modules within our digital telehealth platform.

· Generate and present detailed financial reports on revenue cycles, payer performance, and write-off trends to the executive leadership team.

Requirements & Qualifications

Education & Mandatory Credentials

· Required Certification: Must hold at least one active, unencumbered credential from AAPC or AHIMA (e.g., CPC, CCS, CCS-P, or RHIT).

· Degree: Bachelor’s degree in Healthcare Administration, Finance, Business, or a related field preferred; equivalent experience accepted.

Experience & Skills

· Experience: Minimum of 5 years of experience in healthcare revenue cycle management, with at least 2 years in a dedicated supervisory or managerial role.

· Telehealth Domain Knowledge: Deep familiarity with virtual care billing, including place of service codes (POS 02/10), modifiers (95, GT, FQ), and remote patient monitoring (RPM) reimbursement rules.

· Technical Savvy: Advanced proficiency with medical billing clearinghouses, enterprise EHR billing modules, and Microsoft Excel (advanced formulas and pivot tables).

· Location Constraint: Must reside in Florida to accommodate hybrid workplace requirements and in-state corporate meetings.

Compliance & Legal Disclosures

· Equal Opportunity Employer: PsynergyHealth is an Equal Opportunity Employer. All employment decisions are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability.

· FLSA Status: This position is classified as Exempt under the Fair Labor Standards Act (FLSA). [29]

· Privacy & Healthcare Standards: The Case Manager must maintain absolute compliance with HIPAA and privacy rules, safeguarding sensitive Protected Health Information (PHI) across all digital and telephonic communications. [30, 31, 32]

Core Competencies

· Clinical Credibility: Ability to speak the language of doctors, nurses, and hospital administrators with high authority.

· Problem Solving: Skill in diagnosing complex systemic workflow bottlenecks and designing quick, elegant software workarounds.

· Communication: Exceptional verbal, written, and presentation skills suited for C-suite alignment.

Performance Expectations

Success in this role includes:

· High-quality, patient-centered virtual encounters

· Timely completion of documentation

· Meeting productivity benchmarks

· Active participation in team collaboration and continuous improvement efforts

Why Join Us?

· Be part of an innovative virtual care delivery model

· Flexible work-life balance

· Supportive and collaborative team culture

· Opportunity to shape and grow a cutting-edge Transitions of Care program

· Meaningful impact on patient outcomes during a critical period of care

· Competitive compensation (details provided during interview process)

Apply today and help us create a healthier future, one transition at a time.