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Manager, RCM Services

Sandata Technologies

Not Specified, United States Full-time in I.T. & Communications
    • Job ID 1805949

    Job Description

    Sandata Technologies is the leading supplier of software technology solutions serving home care and I/DD agencies, managed care organizations, and state payer programs throughout the United States. The Sandata solution has been implemented by 15,000 Provider Agencies, 18 State Payers, and 50 MCO Payers to ensure their compliance with changes in regulatory/compliance requirements and ongoing complexities. We make it easier for these organizations to work together and to manage their businesses while also getting paid as quickly as possible.

    At Sandata, we are committed to creating a real and measurable Diversity, Equity, and Inclusion initiative. We will create a work culture where we are curious, celebrate, respect, and appreciate our unique diverse stories, and how we’ve come to where we are. We will do everything possible so that people know that we care about them as an individual and work to build equity in our people, systems, and processes. We are continuing to grow our efforts, and we will grow further together.

    Duties:
    The Revenue Cycle Manager is responsible for overseeing revenue cycle management including billing, collections, and denial management as well as financial reporting within the organization. This position is responsible for ensuring claims, denials, and appeals are efficiently processed, and resolving billing-related issues. The Revenue Cycle Manager will minimize bad debt, improve cash flow, and effectively manage accounts receivable. This role will also manage the authorization process. The Revenue Cycle Manager will be the main contact for the Practice Management vendor, Medicare contacts, and Clearing House vendor. They will be responsible for setting the annual practice fee schedule.

    Essential Functions:
    Oversee and manage entire revenue cycle including billing, coding, collections, and denial management
    Manage relationships with external vendors for practice management software and clearinghouse vendor
    Communicate professionally with various payers and projects.
    Manage, develop, and mentor all revenue department staff, including billers and coders
    Oversee the admission process and manage the admissions team
    Responsible for management and maintenance of billing and practice management software platform
    Provide up to date education for clinical, billing, and coding staff on coding trends
    Develops, evaluates, implements, and revises policies and procedures related to billing, coding, reimbursement activities and improvement strategies
    Reconcile all receivables and revenue reports and work closely with the finance department in the development of the monthly financial statements
    Manage and update the rates in the designated system related to the agency.
    Review and resolve issues related to claim generation and rejected/denied billings.
    Keeps abreast of all reimbursement billing procedures of third party and private insurance payers and government regulations.
    Maintains appropriate internal controls over accounts receivable, RCM process
    Monitors accounts sent for collection and reimbursements from insurance companies and other third-party payers
    Reviews, monitors, and evaluates third party reimbursement and research variances
    Participates in the development of coding and billing strategies, evaluating process relative to revenue cycle.
    Twenty percent Travel is required.

    Skills/Qualifications
    3 years experience in health care billing with knowledge of the use of procedure codes and authorizations, preferably for home healthcare in a Medicaid MCO payer environment
    3 years experience in payroll processing, computation, and compliance with regulations
    Ability to plan appropriately to meet specific processing deadlines
    Ability to communicate appropriately and develop relationships internally and externally
    Knowledge of Microsoft Office applications – Outlook, Excel, Word
    Knowledge of, or ability to learn and operate, Sandata Agency Management applications and processes
    Experience with Homecare or I/DD

    Perks and Benefits:
    Medical, dental, and vision coverage
    Flexible Spending Account for health and dependent care
    Health Savings Account
    BenefitsVIP/Health Advocate
    Company paid Life insurance and STD
    401(k) Plan
    Aflac STD, LTD, Critical Illness, Hospital, and Accident insurance
    Employee Assistance Program
    Tuition reimbursement & paid certification programs
    In-house product training programs
    Catalog of training courses for skills development
    Career Pathing for every department
    Employee Resource Groups (BIPOC, LGBTQ, Women, Military Veterans)
    Paid vacation, sick days, and holidays
    Paid lunch break
    Employee discounts and company perks
    Casual work environment
    Remote work
    Frequent employee events and fun social clubs

    Interview Process:

    1st Round – Hiring Manager (30 Minutes)

    2nd Round – CCO (30 Minutes)

    Sandata Technologies is an Equal Opportunity Employer M/F/Disabled/Vet

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