About us

Our mission is to deliver healthcare solutions to patients and providers, better and faster. Founded in 2011, we have over 50 employees across Southern California and Hawaii, and focus in the areas of DME, Biologics, and Surgical Devices. We work with specialists in orthopedics, woundcare, and general surgery.

Core Values

• We are Humble
• We are Trustworthy
• We are Efficient
• We Take Ownership

JOB SUMMARY:

The Manager, Revenue Cycle Management will report directly to the ownership team. This team member is responsible for leading operational, programmatic, and financial activities of CADE Medical's DME revenue cycle. Serves as a key leader within the assigned area and provides expertise and direction to revenue cycle/billing centers and intake locations charged with maximizing reimbursement and minimizing bad debt write-offs.

The ideal candidate will lead our team of local and off-shore employees in the proper execution of all revenue cycle activities related to our DME billing business. This is an on-site role, and remote employees will not be considered. Relocation expenses may be discussed with ownership.

JOB RESPONSIBILITIES & DUTIES:

• Lead the day-to-day operations of Revenue Cycle department, including but not limited to: insurance verification/pre-auth validation, capturing/updating patient registration and demographic information, defining/documenting front-end policies and procedures, collection of patient responsibility (co-pays, outstanding balances), managing insurance data and validating accuracy/completeness in EMR and billing systems (e.g., coverage dates and place of service), ensuring clean claims submission, managing claims rejections/denials and coordination of benefits, ensuring timely and accurate posting of payer and patient payments, credit balance management, and partnering with our call center.
• Assist with managing the relationship and performance of third-party vendors responsible for systems, technology, and revenue cycle functions (billing, payment posting and AR/denial management and collections).
• Serve as the subject matter expert and point of contact for all revenue cycle tasks, processes, escalations.
• Develops, implements, and maintains functional specific administrative and operating policies and procedures ensuring consistency within other areas of Revenue Cycle.
• Develops key performance indicators, dashboards, and system improvements to improve visibility and efficiency of the revenue cycle process.
• Monitors functional area performance in connection with these metrics and Revenue Cycle overall performance, proactively identifying opportunities for improvement and communicating these opportunities with appropriate leadership/areas.
• Directs all activities for assigned revenue cycle areas, ensuring optimal revenue collection and patient satisfaction with the billing experience, continuously improving processes and policies based on feedback from patients and operations teams.
• Responsible for growing and mentoring the billing, claims, and collections team to ensure productivity and KPI metrics are met in order to achieve strategic goals around reimbursement (timely, consistent and predictable cash flow).
• Works closely with finance, patient care team, and operations leaders to provide key operational insights into the RCM process in order to assist with effective cash flow and working capital modeling.
• Works closely with IT to optimize the use of technology to automate revenue cycle functions.
• Responsible for ensuring compliance with third party payor requirements as well as all applicable state/federal laws and regulations.
• Perform additional job duties as assigned.

Requirements:

• DME revenue cycle experience required
• On-site in the Temecula, CA office
• Bachelor’s degree, preferred
• Brightree experience, preferred
• At least 5 years of experience in the healthcare industry in revenue cycle management leadership role, including experience with revenue cycle, billing, payment posting, AR/denials management, and patient financial services
• Expert understanding of Healthcare reimbursement/collections, medical billing, ICD10 coding, patient documentation, chart auditing, and state and federal regulations
• Demonstrate organizational skills
• Demonstrate effective verbal and written communication skills
• Demonstrate analytical skills when problem-solving
• Demonstrate high attention to detail and a high degree of accuracy

Job Type: Full-time

Pay: From $70,000.00 per year

Benefits:

• 401(k)
• Health insurance
• Paid time off

Schedule:

• Monday to Friday

Supplemental pay types:

• Bonus pay

Ability to commute/relocate:

• Temecula, CA 92590: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

• Which medical billing platforms / applications are you familiar with?

Experience:

• Medical billing: 4 years (Preferred)

Work Location: In person

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