Sacramento Heart & Vascular Medical Associates is one of Northern California’s foremost specialty groups in the diagnosis and treatment of cardiovascular disease. We have an immediate opening for a full-time medical billing Revenue Cycle Manager seeking employment in a fast-paced environment. This position requires a local presence from our main office centrally located in Sacramento, CA. This position is not currently a remote position.
Role and Responsibilities
The Revenue Cycle Manager is responsible for directing, managing, and coordinating the overall functions of the medical billing and coding office to ensure maximization of cash flow while improving patient, physician, and other customer relations. Requires strong managerial, leadership, and business office skills, including critical thinking and the ability to produce and present detailed billing activity reports.
The position supports the company’s overall Billing operations and its staff and client services by efficiently and effectively providing account data needed for the revenue cycle process and delivering results. Must have knowledge of billing operations and procedures; participates in quality assurance and compliance, insurance contract review. Follows protocols according to established billing standards in accordance with Sacramento Heart & Vascular Medical Associates (SHVMA) Billing Department.
- Oversees the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management.
- Serves as the practice expert and go to person for all coding and billing processes.
- Plans and directs patient insurance documentation, workload coding, billing and collections, and data processing to ensure accurate billing and efficient account collection.
- Analyze billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues.
- Maintains contacts with other departments to obtain and analyze additional patient information to document and process billings.
- Prepares and analyzes accounts receivable reports, weekly and monthly financial reports, and insurance contracts in concert with the Practice Administrator. Collects and compiles accurate statistical reports.
- Audits current procedures to monitor and improve efficiency of billing and collections operations.
- Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol, and follow Federal, State, and payer regulations, guidelines, and requirements.
- Participates in the development and implementation of operating policies and procedures.
- Analyzes trends impacting charges, coding, collection, and accounts receivable and take appropriate action to realign staff and revise policies and procedures. Works with internal Administration and Partners to calculate and report company’s liabilities and receivables.
- Keep up to date with carrier rule changes and distribute the information within the practice.
- Understands and remains updated with current coding and billing regulations and compliance requirements.
- Maintains a working knowledge of all health information management issues such as HIPAA and all healthcare regulations.
- Supervises billing office personnel, which includes work allocation, training, and problem resolution; evaluates performance and makes recommendations for personnel actions; motivates employees to achieve peak productivity and performance.
- Establish and maintain effective working relationships with patients and staff.
- Maintain regular and punctual attendance. Time off restrictions around each month end period due to reporting requirements; last week of month and first three business days of the next month.
- Possible travel from main clinic to satellite clinics.
- Effectively and efficiently communicate with physicians and other departments about coding procedures as needed.
- Perform other duties, as needed.
Qualifications and Education Requirements
- Bachelor’s degree in finance or accounting required; or equivalent combination of education and experience.
- 8 years’ experience in medical insurance and healthcare billing.
- Management of at least 5-10 direct employee reports.
- Collections experience in a medical practice or health system, with a deep understanding of medical billing rules and regulations.
- Certified Coder certificate a plus.
- Understanding of medical billing, collections and payment posting, revenue cycle, third party payers, Medicare; strong knowledge of California and Federal payer regulations.
- Working knowledge of CPT and ICD10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits, and appeal process.
- Must have experience working with at minimum Medicare, Medi-Cal, River City Medical Group, and Molina insurances.
- Thorough understanding of medical billing, collections and payment posting, revenue cycle, third party payers, Medicare; strong knowledge of California and Federal payer regulations.
- Knowledge of healthcare policies for all clinical practices and applicable laws and regulations governing proper clinical practice; ability to demonstrate ethical behavior in diverse situations.
- Experience with ASC (Ambulatory Surgical Center) coding regarding Pacer’s, ICD’s a plus.
- Experience in UB facility billing for various private and Medi-Cal GMC based insurances.
- Attention to detail, able to prioritize workload.
- Able to work independently and as a member of a team.
- Proficient computer skills.
- Excellent written and verbal communications skills.
- Strong organizational and planning skills.
- Proficiency in MS Office and Patient Management software.
- Bilingual preferred.
Working Conditions
Office setting, with moderate noise level.
Physical requirements
Requires full range of body motion including manual and finger dexterity and hand-eye coordination. Requires sitting for extensive periods of time with occasional standing and or walking. Occasionally lifts and carries items weighing up to 10 pounds. Requires corrected vision and hearing to normal range.
California Pay Transparency Statement
Compensation for this role at Sacramento Heart & Vascular Medical Associates (SHVMA) depends on a wide array of factors including but not limited to role, skill set and level of experience. As required by state or local law, SHVMA provides a reasonable pay scale to include the hourly or salary range that SHVMA reasonably expects to pay for this role as stated within this job posting.
Sacramento Heart & Vascular Medical Associates is an equal opportunity, affirmative action employer, and is committed to providing employment opportunities to all qualified applicants without regard to race, color, religion, age, sex, sexual orientation, gender identity or expression, national origin, disability or protected veteran status.
Job Type: Full-time
Pay: $95,000.00 - $110,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Experience:
- Medical Billing: 5 years (Preferred)
- Medical Contract: 5 years (Preferred)
- Medical Collection: 5 years (Preferred)
- Management: 5 years (Preferred)
- Full Revenue Cycle: 5 years (Preferred)
Work Location: In person