RCM Supervisor

OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases. Our team is bringing together leaders to the market place to help drive OneOncology’s mission and vision.

Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, urology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of independent physicians and the patients they serve.

Job Description:

Role Summary

The RCM Shared Service Supervisor will be responsible for managing the daily RCM operations at one of our partnered practices. The individual will need to have expertise in medical billing and collections, as well as a strong understanding of insurance authorizations, coverage and benefits, reimbursement processes and regulations related to Oncology services. The successful candidate will collaborate closely with patients, physicians, and insurance companies to ensure that KPIs are met, and clients are satisfied with the services rendered.

Role Responsibilities

• Assist staff in auditing and posting charges when necessary.

• Assist with proper selection of ICD10, HCPCS, and CPT codes.

• Work with practice to resolve any issues with interface files.

• Monitor accounts receivable for all Oncology services provided to patients.

• Oversee authorizations training staff and maintaining up to date knowledge of coverage guidelines related to drug, lab, procedure, and imaging authorizations.

• Manage coverage and benefit workflows including triaging insurance code requests for maintenance of the practice management system.

• Follow up with insurance companies to ensure timely payment of claims related to shared service lines.

• Investigate and assist in resolving any outstanding insurance and patient balances related to shared service lines of business including claim rejections, denials, and appeals.

• Review and interpret insurance policies and regulations related to shared services to ensure compliance with billing and collection requirements.

• Work collaboratively with the practices to ensure accurate and complete billing is received timely.

• Maintain accurate and up-to-date records of collections activities in patient files and computer systems.
• Monitor and track claims through the denial process to ensure timely payment and identification of payer roadblocks.

• Stay current with industry trends, changes to insurance policies, and other developments that may impact the collections process.

• Monitors and assesses business metrics to refine processes and improve efficiencies including benchmarking. Prepare reports for clients and leadership related to performance and productivity.

• Prepare payroll records and maintain employee attendance/audits for HR payroll processing.

• Manage employee activity such as hiring, job performance, evaluations, and disciplinary actions with appropriate approvals as required.

• Lead team meetings and prepare minutes for distribution to team and management.

• Other duties as assigned to help drive our mission of improving the lives of everyone living with cancer.

Qualifications

• Strong knowledge of medical terminology and procedures related to Oncology/Hematology

• Excellent communication skills, both verbal and written

• Ability to work collaboratively with a diverse group of individuals, including physicians, patients, insurance providers, and pre-authorization teams.

• Strong organizational and time management skills

• Ability to work independently and manage multiple priorities in a fast-paced environment.

• Proficiency in medical billing software and other computer programs used for record keeping and data analysis.

• Knowledge of Windows-based software applications. (E.g.: Word, Excel, Outlook…)

• Minimum of 3 years of experience in healthcare RCM required, preferably in an Oncology healthcare setting.

• Prior management experience preferred.

• Project management preferred.

• Expertise in insurance policies and regulations related to medical billing, including Medicare and Medicaid