Job Description

Job Description

Job Description

Nilsen Eye Care (NEC) has been in the Richmond market for over 25 years and is a fast-growing, two-location private Optometry practice with 10 Doctors of Optometry. With the motto of “See the Difference Caring Makes,” we are dedicated to caring for the overall health of our patients through comprehensive vision and preventative medical eye care. We want every patient to achieve their best visual outcome and to trust us to do a great deal more than just provide the best contact lenses and eyewear. We are looking for a Revenue Cycle Manager who brings that same level of commitment to NEC 's exceptional eye care services while ensuring financial integrity. We believe that meaningful work should also be rewarding and fun
The RCM Manager is responsible for, participates in and leads the overall strategy for the optimization of over 7 million in revenue collections for Nilsen Eye Care. This position is accountable for all aspects of revenue cycle management, including the efficient and effective day-to-day operations and management of 4 RCM staff.
Responsibilities Manages the training, ongoing evaluation, and development of RCM staff to ensure the accuracy of patient billing information.

• Develops, adopts, and implements policies and procedures for all Revenue Cycle functions specific to locations and clients to maximize collections.
• Interprets, prepares, and disseminates new insurance plan information and changes in policies to all appropriate departments of NEC.
• Maintains and ensures timely submission of all claims/orders to payers, including oversight for submissions by RCM staff and contract vendors.
• Ensures patient statements are sent out on a weekly basis following collection policies and procedures as adopted by NEC.
• Monitors and ensures that both insurance and clearinghouse claim denials are addressed daily.
• Ensures all payment posting and contractual adjustments are conducted timely and accurately.
• Manages relationships with vendors ensuring timeliness of responses and quality of services in a professional manner.
• Engages and interacts with the owners and all the providers to NEC providing governmental and insurance updates with education sessions as appropriate.
• Manages credentialling and recredentialling of all established and new providers in a timely manner.
• Manages and maintains accountabilities for all accounts receivable and the follow-up activities associated with aging payer categories.
• Produces and distributes reports with relevant data which demonstrates the status and progress of adopted maintenance and improvement-based goals.

• 5 years of medical billing experience, 3 years of supervisory or management experience within the medical billing arena
• Knowledge of medical billing and coding processes and rules, vision insurance knowledge a plus
• Oral and written communications skills
• Healthcare Practice Management and EMR software experience
• Experience developing compliant RCM policies and procedures
• Claims denial management experience.
• Department workflow design experience with a concentration on effectiveness and efficiencies
• Optometry or Ophthalmology experience preferred.

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