Senior Manager RCM (51246)

Who We Are:

Platinum Dermatology Partners is a network of high-quality dermatology clinics that focus on collaborative and innovative ideas to drive growth. We offer general dermatology, cosmetic, medical, plastic surgery, and cancer screening treatments. We have over 145 clinics, over 350 providers, and more than 2300 employees in clinics across Texas, Arizona, California, Nevada, and Florida. We are a rapidly growing company that allows our doctors to focus on providing exceptional care without worrying about the operational side of the business. Our core values focus on collaboration, ownership, respect, excellence, authenticity, and integrity. Our purpose is to empower the practice of exceptional dermatology.

Company Conformance Statements:

In the performance of their respective tasks and duties, all employees are expected to conform to the following:

• Perform quality work within deadlines with or without direct supervision.
• Interact professionally with other employees, customers, and suppliers.
• Work effectively as a team contributor on all assignments.
• Work independently while understanding the necessity for communicating and coordinating work efforts with other employees and organizations.

Position Summary:

The Senior Manager of Revenue Cycle is responsible for overseeing and optimizing all aspects of the healthcare revenue cycle, including authorizations, claims management, denial management/prevention, reimbursement, and accounts receivable performance. This role ensures efficient revenue cycle operations, regulatory compliance, and achievement of financial performance goals while providing support to revenue cycle staff.

The Senior Manager partners closely with leadership, clinical departments, finance, compliance and payer representatives to drive revenue cycle performance and achieve organizational financial goals.

Principal Duties and Responsibilities:

• Manage day-to-day revenue cycle activities from authorization to final account resolution.
• Monitors revenue cycle performance metrics and implement process improvements as needed.
• Works collectively with the VP of RCM to conduct ongoing analysis of RCM/cash flow cycle for all corporate markets.
• Oversee accounts receivable management and collection efforts to achieve cash targets.
• Develop action plans to address performance gaps and improve revenue outcomes.
• Acts as a key liaison for review and analysis of RCM-related questions and concerns within the provider community surrounding cash-flow questions and concerns.
• Monitor and analyze revenue cycle trends to reduce claim denials and improve first-pass claim acceptance rates.
• Educates the provider community on corporate RCM workflow design and opportunities for clinic-based improvement(s).
• Collaborate with clinical and operational departments to assist in resolving the root cause of denials.
• Performs Practice Due Diligence as it relates to RCM Processes & Procedures and identifies opportunities for process improvement.
• Ensure timely and accurate claim submission and reimbursement processes.

Qualifications/Experience: 

• Bachelor’s degree in Healthcare Administration preferred.
• Minimum of 5 years of RCM experience in a healthcare setting required with management level experience in applying general reimbursement principles.
• Strong knowledge of Medicare, Medicaid, OIG, and related regulatory and commercial insurance billing and collection procedures.
• Excellent presentation skills including written and verbal communication expertise.
• Full working knowledge of Microsoft Office, including Word, Excel skills and PowerPoint. Must have ability to produce and maintain reports and templates, incorporating the use of complex formulas, charts, and graphs.
• Strong analytical skills required to identify trends, explain root causes, and drive changes to mitigate A/R.
• Experience with electronic health record (EHR) and revenue cycle management systems.
• Demonstrated success improving revenue cycle performance metrics.

Skills:

• Advanced analytical and financial management capabilities.
• Knowledge of Revenue Cycle practices and end-to-end workflow design.
• Proficiency with healthcare financial reporting and data analytics tools.
• Foster a culture of accountability, continuous improvement, and excellence.
• Independently manage RCM data sets and draw summary conclusions on overall state of cash flow.
• Ability to create positive relationships within the provider community and corporate/clinical staff.
• Strong problem-solving abilities while being able to clearly present information to providers and leadership.
• Ability to achieve and maintain minimum departmental performance and quality standards.
• Ability to work effectively with co-workers as a team member and to communicate clearly.

Our competitive benefits package includes the following:

• Medical, Dental, and Vision insurance
• Short-term/Long-term disability
• Life and other voluntary plans
• 401(k) plan
• Employee Referral Program
• Paid Time-Off
• Company-Paid Holidays

Equipment Operated: Standard office equipment including computers, fax machines, copiers, printers, telephones, etc.

Physical Requirements: Must possess manual dexterity to operate office machines including computer and calculator; stooping and bending to handle files and supplies; and mobility to complete errands or deliveries. Includes handling of sharps and chemicals.

Equal Employment Opportunity:

Platinum Dermatology Partners is committed to a policy of equal employment opportunities for applicants and Employees. Employment decisions will comply with all applicable laws prohibiting discrimination in employment, including Title VII of the Civil Rights Act of 1964, The Age Discrimination in Employment Act of 1967, the Americans with Disabilities Act of 1990, the Immigration and Nationality Act, the California Fair Employment and Housing Act, and all other applicable state and federal laws.

Platinum Dermatology Partners does not permit discrimination of any type against an employee because of any of the following legally protected characteristics: gender, race, color, religion, country of origin, mental disability, physical disability, marital status, gender identity, gender expression, ancestry, genetic information, medical condition, age, sexual orientation, or pregnancy.

Please note, that any offer of employment is contingent on the successful completion of pre-employment background checks.

No phone calls or agencies, please.