CBO Billing Relations Manager

Position Summary / Scope of Responsibility

Functions as a floating Revenue Cycle leader by providing interim management coverage, operational support, special project leadership, and hands-on claims assistance across multiple RCM teams as organizational needs dictate.

Primary Responsibilities

The incumbent may be asked to perform job-related tasks other than those specifically stated in this description. The duties and responsibilities of the position are to be carried out in a manner that is consistent with the Mission, Core Values and Operating Principles of MedVanta.

• Serves as primary point of contact for the Divisions regarding front-end revenue cycle matters.
• Ensures a good understanding of services provided by Divisions and how these services are accurately billed to payers.
• Supports operations as appropriate in calls or face-to-face meetings with Divisions to resolve reimbursement issues.
• Works collaboratively with coding and compliance departments to ensure providers receive appropriate training and feedback.
• Manages the overall Accounts Receivable function and team.
• Oversees and streamlines billing and collection processes.
• Performs special program and billing planning and implementation.
• Ensures healthcare facilities are reimbursed for all procedures.
• Handles information related to patient treatment, diagnosis, and procedures to ensure proper coding.
• Investigates insurance fraud and reports findings as appropriate.
• Reviews A/R reports to ensure claims are paid by insurance carriers or patients in a timely manner.
• Provides leadership coverage and operational oversight for other Revenue Cycle Management teams during manager absences, vacancies, or periods of increased operational need.
• Supports cross-functional Revenue Cycle departments by serving as a flexible management resource to ensure continuity of operations and team performance.
• Leads and participates in special projects, process improvement initiatives, and strategic assignments as directed by the Vice President of Revenue Cycle Management.
• Collaborates with leadership on departmental initiatives focused on operational efficiency, reimbursement optimization, workflow enhancements, and staff support.
• Assists with claims follow-up, resolution, and other revenue cycle operational activities during periods when project work or management coverage responsibilities are limited.
• Performs hands-on revenue cycle functions as needed to support departmental productivity goals and organizational priorities.
• Performs all other duties as assigned.

REQUIREMENTS AND COMPETENCIES

Required

Education and Experience

• Bachelor’s degree in Business, Finance or related discipline preferred.
• 5+ years of related manager-level experience, with experience in an orthopaedic setting preferred.
• Certified Professional Coder (CPC) preferred.
• Proficiency with Microsoft Office suite of products as well as practice management and electronic health record systems.
• Extensive knowledge of insurance, benefits, medical terminology, and medical billing.
• Experience working with billing and accounts receivable for both commercial and non-commercial payors.
• Demonstrated experience in leadership and supervision, as well as financial management and resource allocation.
• Knowledge of multiple coding systems, including Level 1 HCPCS and Level 2 HCPCS.

Competencies / Required Skills and Abilities

• Strong interpersonal skills - ability to develop relationships and collaborate and influence in a centralized organization.
• Demonstrated ability to organize, prioritize, and manage multiple tasks in a dynamic environment with a proven track record of results.
• Strong interpersonal, oral, and written communication skills with excellent self-discipline and patience.
• Able to work independently.
• Exudes professionalism in presentation.
• Must be able to read, write, speak, understand, and communicate in the English language.

Physical Demands

• Must be able to sit for long periods of time and lift up to 25 pounds.
• Must be able to use appropriate body mechanics techniques when performing desk duties.
• Requires frequent bending, reaching, repetitive hand movements, standing, walking, squatting, and sitting.
• Adequate hearing to perform duties in person and over telephone.
• Must be able to communicate clearly to patients in person and over the telephone.
• Visual acuity adequate to perform job duties, including reading materials from printed sources and computer screens.