Position Summary / Scope of Responsibility

MedVanta is the nation's largest physician-owned and operated next generation management services organization (MSO). Our services are specifically designed for musculoskeletal (MSK) providers and go beyond that of a traditional MSO, empowering our clients with the precise infrastructure, data, technology, and administrative processes needed to thrive both today and tomorrow.

MedVanta has an employee centered culture that supports and promotes diversity and inclusion. Our encouraging and empowering management style makes MedVanta a great place to further grow your knowledge while building a team driven path to success.

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.