Sr. Manager, Revenue Cycle

About the role

This full-time hybrid role requires working in the office on Tuesdays and Thursdays at 1200 Binz St Suite 1490 Houston TX 77004. Monday, Wednesday, and Friday are typically work from home but may be in office on occasion. Under the direction of the Associate Director, Director, or AVP of Revenue Cycle Management, the Senior Manager, Revenue Cycle Management, is responsible for oversight and training of staff, management of functions and processes and accountable for the team hitting performance, quality and production metrics. In addition, the Sr. Manager will support the Gulf Coast Market RCM Associate Directors with escalations and larger strategic projects as needed.

Responsibilities

• Oversee the entire claims submission and follow-up process, ensuring claims are worked accurately for resolution, submitted accurately and on time
• Lead and manage large payer projects and care center support projects, updating leadership and affected stakeholders as needed
• Keep Associate Directors and AVP abreast of opportunities for improvement in daily operations along with recommendations on process improvements
• Manage the teams accountable for the accounts receivable (AR) including analysis and resolution of the aged AR, looking for root cause issues
• Utilize data to identify patterns in claim denials or delays and develop actionable solutions to address them
• Independent decision making regarding claim adjustments, resubmission, appeals, and other claim resolution techniques
• Make policy updates as needed to all RCM policies
• Meet with the Performance Operations, Implementation, Sales and other Privia teams, review escalated issues and discuss payer or claim concerns
• Meet with Care Center leadership including the lead physician partners, office managers and other staff to discuss complex claim or other revenue cycle matters
• Drive achievement of department’s daily and monthly KPIs, requiring a team focused approach to attainment of these goals
• Identify gaps in the workflow and create training programs to address them
• Perform or assist with duties related to staffing to include hiring, termination, coaching and training
• Provide ongoing feedback to staff regarding performance throughout the year
• Counsel employees in disciplinary matters and obtain assistance from human resources appropriately for disciplinary actions and/or employee termination process
• Serve as the lead or co-presenter at various meetings, including Office Manager Summits, Provider POD Meetings, and Market Retreats
• Other duties as assigned

Qualifications

• High School Graduate, Medical Office training certificate or relevant experience
• 5+ years experience in managing physician revenue cycle
• 3+ years experience in management of personnel
• Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims
• Strong preference for experience working with athenaOne, Trizetto and Salesforce
• Must comply with HIPAA rules and regulations

Pay

The salary range for this role is $75,000.00–$80,000.00 in base pay and exclusive of any bonuses or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). This role is also eligible for an annual bonus targeted at 15% and restricted stock units. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.