Manager, Revenue Cycle Operations

Company: Exagen Inc.
Location: Vista
Posted on: February 21, 2021

Job Description:

Exagen is a patient-focused and discovery-driven life sciences company dedicated to transforming the care continuum for patients suffering from debilitating and chronic autoimmune diseases.--Our goal is to enable rheumatologists to improve care for patients through the differential diagnosis, prognosis, and monitoring of complex autoimmune and autoimmune-related diseases, including lupus and rheumatoid arthritis.--By leveraging our proprietary Cell-Bound Complement Activation Products, or CB-CAPs, technology, we help get to the real cause of a patient's symptoms and guide their journey to improved health.About the Opportunity The Manager, Revenue Cycle Operations works with the Director, Revenue Operations and Director, Billing Strategy and Analysis to provide direction and leadership to department staff. This position involves supervising, training, and motivating employees to achieve peak productivity and performance. This position will oversee the medical collections for various regional and national payers, including Federal, State, Third Party (HMO, PPO, IPA, and TPA Indemnity), Patient Collections, and Hospital Collections.Qualified candidates will have extensive knowledge of medical and third-party billing procedures, policies and concepts, thorough understanding of Federal and State health programs, PPO, HMO, and Indemnity Plans structure. This is a terrific opportunity to motivate, inspire employees while creating a culture of success!Responsibilities* Prepare periodic reports on team effectiveness to establish production and quality standards* Prepare and present monthly reporting results to Billing and Finance leadership* Review various reports including aging, adjustment requests, and collection agency accounts* Ensure payor reimbursement is aligned with active payor contracts* Review incoming payor settlement agreements and negotiate for maximum reimbursement* Identify payor trends and resolve areas of concern* Collaborate with other departments in order to achieve revenue recognition targets* Train and coach team members; provide performance feedback* Review training processes to identify efficiencies and drive improvement* Cultivate, maintain, and enhance intradepartmental and professional relationships* Monitor and evaluate individual performance, provide individual performance feedback and accomplish individual annual reviews on assigned staff* Handle escalated requests with payers, clients and patients* Assist with technology implementation, including project planning and management* Comply with Federal and State legislation pertaining to all billing related mattersMinimum Qualifications* 5+ years' experience in a billing leadership role* Minimum of 3 years' experience in a laboratory setting* Strong understanding of insurance billing, including Medicare, Medicaid, and commercial insurance plans* Working knowledge of appropriate coding systems; CPT, ICD-10, and HCPCS, coverage; LCD/NCD and reimbursement associated with such codes* Strong understanding of Palmetto MolDX program and Diagnostic billing requirements* Effective problem-solving skills in a fast-paced and rapidly changing environment* Proven track record for improving processes* Excellent verbal and written communication skills including the ability to provide training to other departments as well as staff and leadership to new employees* Strong leadership skills with an emphasis on building a positive culture* Must be proficient in Microsoft Outlook, Excel, Word, Power Pivot, and internet research* Quadax experienceBenefitsCompetitive compensation packages - Generous PTO + 10 holidays - Medical, Dental, Vision, FSA, & Dependent Care- 401(k) retirement savings plan match - Life Insurance & DisabilityThe statements herein are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.Exagen is proud to be an equal opportunity workplace. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status. We also consider qualified applicants regardless of criminal histories, consistent with legal requirements.

Keywords: Exagen Inc., Vista , Manager, Revenue Cycle Operations, Executive , Vista, California