Manager, Revenue Cycle Operations
Company: Exagen Inc.
Location: Vista
Posted on: February 21, 2021
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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
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