EmergencyMD
Medicare/Medicaid Revenue Cycle Manager
EmergencyMD, Baltimore, Maryland, United States,
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Responsibilities:
The Medicaid/Medicare Revenue Cycle Manager will support Barrow Wise's Illinois DHS project and perform the following duties:
Manage the entire revenue cycle process, including billing, coding, collections, and denial management
Monitor the accuracy and efficiency of patient billing information
Review and resolve issues related to claim generation and rejected/denied billings
Communicate professionally with various payers, including Medicare
Implement coding changes and provide coding education to clinical and coding/billing staff
Provide day-to-day supervision, development opportunities, training, and mentorship
Increase reimbursements and provide revenue optimization
Conduct monthly analysis of Medicare and Medicaid
Develop and execute process improvements related to revenue cycle management
Optimize cash flow, minimize bad debt, and improve overall financial performance
Provide and manage consulting, data transfer, and claims processing services to increase federal revenues in Medicare A, B, D, and Medicaid in IDHS State Operated Facilities
Provide revenue maximization services for Medicare A, B, D, and Medicaid
Enhance billing and coding accuracy, claims management, eligibility verifications, regulations, and compliance with recommendations and implementation of training, new systems, processes, and automation
Provide and manage services to process Medicare D claims and collection as required by Federal Medicare D rules and requirements; ensure a streamlined and compliant billing and collection function, including an electronic accounts receivable system specific to pharmacy claiming
Review and assess the current Medicare Part A & B, Medicaid, claiming policies, procedures, practices, and outcomes of each State-operated facility for mental health and developmental disabilities
Assist the State with billing Medicare Part A & B and Medicaid programs; provide IDHS with detailed information identifying those claims that the vendor submitted in an agreed-upon format and frequency
Assist the State in the completion of annual Medicare cost reports by reviewing Medicare cost report schedules to ensure reports are completed appropriately and maximize Medicare and Medicaid cost reimbursement
Implement processes to improve billing and claiming with the transition to State staff
Provide recommendations as to the level and expertise necessary for individuals to conduct billing and claims to achieve optimal revenue
Develop and deliver training, documents, manuals, and other resources required to promptly identify and correctly bill for eligible individuals served by the DHS State-Operated Facility programs
Work as a mediator between the State and the Fiscal Intermediary NGS (National Government Services), which requires them to answer questions related to the Medicare cost reports, billings and claims
Assist the IDHS Office of Fiscal Services with the submission of Medicare bad debt claiming
Assist the IDHS Office of Fiscal Services with the submission of annual Medicare cost reports
Identify additional revenue maximization opportunities for IDHS
Develop reports and present data to the State
Utilize influence to eliminate bottlenecks and potential resource alignment problems
Work remotely
An ideal candidate has the following:
U.S. Citizenship
Bachelor's degree
7 years of experience with Medicare and Medicaid revenue maximization services
Expert in automation in healthcare claims and holds a coding certification
Proficient in Financial Analysis, Project Management, and Business Analysis practices, principles, and tools
Excellent written and verbal communication skills
Join the team at Barrow Wise Consulting, LLC for a fulfilling and engaging experience! Our team is dedicated to providing innovative solutions to our clients in an ethical and diverse work environment. We offer competitive compensation packages, excellent benefits, and opportunities for growth and advancement. Barrow Wise is an equal-opportunity, drug-free employer committed to diversity in the workplace. Minority/Female/Disabled/Protected Veteran/LBGT are welcome to apply.
Our employees stand behind Barrow Wise's core values of integrity, quality, innovation, and diversity. We are confident that Barrow Wise's core values, business model, and team focus create positive career paths for our employees. Barrow Wise will continue to lead the industry in delivering new solutions to clients and persevere until the client is overjoyed.
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Responsibilities:
The Medicaid/Medicare Revenue Cycle Manager will support Barrow Wise's Illinois DHS project and perform the following duties:
Manage the entire revenue cycle process, including billing, coding, collections, and denial management
Monitor the accuracy and efficiency of patient billing information
Review and resolve issues related to claim generation and rejected/denied billings
Communicate professionally with various payers, including Medicare
Implement coding changes and provide coding education to clinical and coding/billing staff
Provide day-to-day supervision, development opportunities, training, and mentorship
Increase reimbursements and provide revenue optimization
Conduct monthly analysis of Medicare and Medicaid
Develop and execute process improvements related to revenue cycle management
Optimize cash flow, minimize bad debt, and improve overall financial performance
Provide and manage consulting, data transfer, and claims processing services to increase federal revenues in Medicare A, B, D, and Medicaid in IDHS State Operated Facilities
Provide revenue maximization services for Medicare A, B, D, and Medicaid
Enhance billing and coding accuracy, claims management, eligibility verifications, regulations, and compliance with recommendations and implementation of training, new systems, processes, and automation
Provide and manage services to process Medicare D claims and collection as required by Federal Medicare D rules and requirements; ensure a streamlined and compliant billing and collection function, including an electronic accounts receivable system specific to pharmacy claiming
Review and assess the current Medicare Part A & B, Medicaid, claiming policies, procedures, practices, and outcomes of each State-operated facility for mental health and developmental disabilities
Assist the State with billing Medicare Part A & B and Medicaid programs; provide IDHS with detailed information identifying those claims that the vendor submitted in an agreed-upon format and frequency
Assist the State in the completion of annual Medicare cost reports by reviewing Medicare cost report schedules to ensure reports are completed appropriately and maximize Medicare and Medicaid cost reimbursement
Implement processes to improve billing and claiming with the transition to State staff
Provide recommendations as to the level and expertise necessary for individuals to conduct billing and claims to achieve optimal revenue
Develop and deliver training, documents, manuals, and other resources required to promptly identify and correctly bill for eligible individuals served by the DHS State-Operated Facility programs
Work as a mediator between the State and the Fiscal Intermediary NGS (National Government Services), which requires them to answer questions related to the Medicare cost reports, billings and claims
Assist the IDHS Office of Fiscal Services with the submission of Medicare bad debt claiming
Assist the IDHS Office of Fiscal Services with the submission of annual Medicare cost reports
Identify additional revenue maximization opportunities for IDHS
Develop reports and present data to the State
Utilize influence to eliminate bottlenecks and potential resource alignment problems
Work remotely
An ideal candidate has the following:
U.S. Citizenship
Bachelor's degree
7 years of experience with Medicare and Medicaid revenue maximization services
Expert in automation in healthcare claims and holds a coding certification
Proficient in Financial Analysis, Project Management, and Business Analysis practices, principles, and tools
Excellent written and verbal communication skills
Join the team at Barrow Wise Consulting, LLC for a fulfilling and engaging experience! Our team is dedicated to providing innovative solutions to our clients in an ethical and diverse work environment. We offer competitive compensation packages, excellent benefits, and opportunities for growth and advancement. Barrow Wise is an equal-opportunity, drug-free employer committed to diversity in the workplace. Minority/Female/Disabled/Protected Veteran/LBGT are welcome to apply.
Our employees stand behind Barrow Wise's core values of integrity, quality, innovation, and diversity. We are confident that Barrow Wise's core values, business model, and team focus create positive career paths for our employees. Barrow Wise will continue to lead the industry in delivering new solutions to clients and persevere until the client is overjoyed.
#J-18808-Ljbffr