Job Description

Manager,Revenue Operations

Business Office · Revenue Cycle Managers
Plantation, FL
Health Care
Full Time, Days
Weekly Schedule: Monday - Friday 8:00am - 5:00pm
Bilingual: Preferred
Bilingual Type: English/Spanish
Posted 03/02/2021
Req # 5867
    • Oversee all operational functions for all Pediatric Associates entities.
    • This list may not include all of the duties that may be assigned.
    • Oversees immediate staff for all functions of payment posting
    • Oversees team’s productivity, audit, track and report problems. Compiles statistical data on a monthly basis
    • Serve as a liaison between Pediatric Associates and Zirmed
    • Meet with fellow managers on a regular basis to ensure continuity on managing staff
    • Stay abreast of all HIPAA electronic transactions including claims (837), remits (835), eligibility (270/271) and claims status (276/277)
    • Audit accounts for compliance
    • Oversee daily claims transmissions including reconciliation to ensure all claims have been received by clearing house
    • Oversee daily payment posting including electronic remittance and mail payments
    • Posting refunds including takebacks from insurance plans
    • Oversees hospital billing including charge posting and accounting for daily hospital rounds
    • Correct entries in computer to ensure proper payment.
    • Research and reconcile Unapplied/Misapplied payments and credit balances
    • Assist with special projects and reports to ensure maximum payments
    • Other various duties as assigned, including cross training in other functional areas.
    • Education:
      • High school diploma or equivalent.

    • Licensure:

    • Knowledge, Skills & Abilities:
      • Knowledge of billing and collection policies and procedures, all types of insurance (HMO, PPO, POS, Medicaid etc.) Skill in defining problems, collection of data, interpreting billing information. Ability to communicate effectively and clearly.

    • Experience:
      • Three years of supervisory or management experience in a medical environment preferred.

    • Adhere to all organizational information security policies and protect all sensitive information including but not limited to ePHI and PHI in accordance with organizational policy, Federal, State, and local regulations.

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