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Ophthalmic Revenue Cycle Manager, MI

Company: The Eye Group
Location: Dearborn Heights
Posted on: September 12, 2020

Job Description:

Provides overall strategy and financial direction of Coding, Billing, Follow-up, Collections, Cash Posting, Refunds/Credit Balances, Denial Management, Bad Debt, and Payor Variance activities to ensure the highest level of accuracy and collection rates. Responsible for the Revenue Cycle processes and controls relating to insurance verification, billing, posting of EOBs, denial management and A/R collections for both patients and insurance. Will perform root cause analysis and correction of billing errors/claim rejections/denials. Provides leadership to the Revenue Cycle team through oversight, training and professional development. Analyzes work flows and determines necessary staffing levels and skill-sets by enhancing and standardizing processes throughout the revenue cycle. Monitors effectiveness of collection efforts and maintains insurance billings are current within the established timeframe specified in the department policy. Analyzes accounts receivable to ensure maximum net revenue realization, stable cash collections, avoidance of denials, and measured reduction in write offs. Performs necessary audits. Develops and communicates monthly reports to leadership. Implements recommendations by outside auditors and consultants. Manages physician credentialing process with managed care and government payers. Assists in the contractual negotiations with third party payers providing profitability analysis of current contract terms and evaluation of payer performance. Serves as the primary contact for all contractual-related payer issues and seeks to maintain positive relationships

Keywords: The Eye Group, Dearborn Heights , Ophthalmic Revenue Cycle Manager, MI, Executive , Dearborn Heights, Michigan

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