Revenue Cycle Manager

  • Dallas, TX, USA
  • Full-time

Company Description

MGA Homecare specializes in providing private duty nursing, personal care services, and therapy to the medically complex population. We deliver high-quality care in the home and community-based setting, the setting which is the lowest cost to the payers. We aim to be the employer of choice and the partner of choice to referral sources, state government agencies, and health plans. We currently provide care in Arizona, Colorado, and Texas, with a plan to grow into new states and markets. 

Job Description

Job Summary

The Collection Manager will be responsible for overseeing the timely collection of outstanding accounts receivables. The manager will work closely with Billing team on claim adjudication, The position will require extensive interaction with state Medicaid (MCO) Plans and will report to the Corporate Director of Revenue Cycle.

Duties and Responsibilities

Billing/Claims Processing:

  • Assists Billing Specialist & Authorizations Specialist in resolving current months rejected or unbilled claims
    • including denials research
    • corrected claim resubmission
    • secondary billing.
  • Produces and presents progress against performance measures
    • Billing Tracker
    • Denial Tracker
    • Monthly Adjustments reporting

Account Management:

  • Accountable for timely collections of outstanding accounts.
  • Communicates with facility staff to gather necessary supplemental information
  • Utilizes payor portals, and payor provider relations lines to timely follow up on submitted, denied and resubmitted claims and appeals.
  • Communicates with Billing Specialists and Authorizations Specialists to gather necessary information for resubmission of claims or processing to secondary/tertiary payers
  • Reviews, corrects, and resubmits claims for internal system-identified errors
  • Prepares documentation for appeals
  • Produces and presents progress against performance measures (Collection Tracker)
  • Participates in monthly account reviews with Director of RCM
  • Participates in other focus reviews as needed
  • Conducts analysis of all accounts to complete timely adjustments to AR/claims, Analyze revenue impact to the Income Statement from adjustments and report findings to upper management.
  • Assists with preparation of state and/or government audit reports as required including quarterly credit balance for Medicaid

Facility Support:

  • Ensures accurate and timely status of assigned accounts during monthly AR reviews.
  • Communicates with supervisor regarding trends and suggested solutions.
  • Completes various administrative activities & performs other duties as assigned.

General Duties and Responsibilities:

  • Responsible for collections of all accounts for the assigned state and payer groups.
  • Performs weekly review of AR aging for all account balances and acts to meet expectations & KPIs
  • Responsible for resolving escalated business issues.
  • Adjust workload timing and request training to meet business needs of the facilities served
  • Supports and executes the mission, ethics, and goals of the company effectively.
    • Represents themselves in a positive and professional manner in the company and community.
    • Adheres to dress code with a clean and neat professional appearance.
    • Reports on time and as scheduled to complete work within designated time.
    • Adhere to all company policies and procedures outlined in Employee Handbook, Employee Agreement, or communicated from executive team.

Qualifications

  • Associate degree or equivalent experience required; Bachelor’s Degree preferred.
  • Minimum 2 years of applicable experience in a healthcare (Homecare preferred) billing and collections environment.
  • Experience working with Texas Medicaid and it’s contracted Managed Care Organizations (MCOs)
  • Understanding of healthcare business service functions, including billing and collections, including HCFA/UB04, in a Homecare environment preferred.
  • Elevated level of customer service experience.
  • Must be proficient in the use of a personal computer and windows environment software with intermediate level of keyboarding skills.
  • Intermediate level of MS Office Products – Word and Excel.
  • Must have strong interpersonal skills including verbal and written communications.

Additional Information

All your information will be kept confidential according to EEO guidelines.

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