Company Statement

Careers at AdvantageCare Physicians: At AdvantageCare Physicians, our providers and care teams reflect our commitment to population health. Improving the health of our patients is our goal; keeping our patients healthy is our commitment. Using our state-of-the-art electronic medical record (EMR) system, our providers, care teams, and practice administration staff work together to deliver high-quality, comprehensive and convenient care to our patients.

 

To protect the health and safety of our workforce, members, patients, and the communities we serve, the EmblemHealth family of companies require all new employees to be fully vaccinated for COVID-19. Exemption/reasonable accommodations may be granted because of 1) a qualifying medical condition or disability that makes getting the vaccine unsafe for the individual, or 2) objection on the basis of sincerely held religious beliefs and/or practices.

Revenue Cycle Project Manager

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Patient Services
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2116F Requisition #
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AdvantageCare Physicians (ACPNY) is one of the largest primary and specialty care practices in New York City. With more than 35 medical offices and over half a million patients across all five boroughs* and Long Island, ACPNY aspires to be a home for health for the communities we serve. This vision is accomplished through a “whole you” care approach that recognizes the physical, mental, and lifestyle factors that impact a patient’s health. When our teams of providers, nurses, and specialists work together, we can get patients in sooner, answer their questions in real time, and give them the support they need to achieve their health goals. ACPNY is also driven by a commitment to diversity, an unyielding desire to deliver high-quality care, and community-focused collaboration. By integrating these behaviors into our day-to-day operations, ACPNY strives to always create healthier futures for our patients.

*BronxDocs medical offices are affiliates of AdvantageCare Physicians.

The Revenue Cycle Project Manager provides guidance and structure to various large and complex billing related Revenue Cycle Projects. Provides data, complex analysis and innovative solutions to ongoing revenue cycle billing issues. 

Responsibilities: 

Revenue Cycle Projects

  • In conjunction with the Rev Cycle Team and Billing Vendor, monitors top payor activity for anomalies and trends to identify new issues, provides accurate supporting data, and works with payors to resolve complex payor issues. 
  • Payor projects may include, but are not limited to, complex reimbursement/underpayments, denial trends, and coding issues. 
  • Tracks projects to completion to ensure full issue resolution and appropriate ACPNY payment.
  • Provides data, analysis and resolution to audit and other requests.

Standard Monthly Reporting and Analysis

  • Oversees the production of standard monthly reports run by the Data Integrity/QA analyst, analyzes results to determine root causes and alerts Rev Cycle team to outliers and new concerns. 
  • Reports, include but are not limited to: 
    • Monthly Adjustments by Category
    • Incentive Program Payments
    • WQ (work queue) Status Reports
    • A/R analysis by Financial Class
  • Assists in the design and development of new, standard and customized, automated EPIC and Qlik reports. 
  • Designs and develops Ad Hoc Reports as needed to answer key Revenue Cycle questions posed by the Rev Cycle and Management Team.

Manages Work Queue Statuses

  • Manages and oversees all daily / weekly and monthly WQ Status reports to ensure that our billing vendor is meeting all SLAs and KPIs for expected turn around times.
  • Identifies any WQ risks and works directly with our vendor management team to define root causes, corrective actions and next steps for managing follow up for remediation around all WQ risks.

Manages Ticket Statuses

  • Oversees and tracks all system tickets opened by the Rev Cycle team to ensure that they are resolved in a timely fashion.
  • Tickets may include: 
  • JIRA (project tracking) requests
  • Experian
  • PB Team

 

 

Qualifications:

  • Bachelor’s degree required, master’s in Health Care Management Preferred
  • Minimum of 5 years progressive experience in Revenue Cycle Management including managed care industry.   
  • Provider experience with High Volume, multi-specialty, multi-physician groups.
  • Knowledge of Epic Billing Application (strongly preferred), or other comparable large scale medical records applications with emphasis on knowledge of its reporting capabilities.
  • Experience with Experian Contract Manager
  • ICD-10 or CPT Knowledge
  • Strong Analytical Skills
  • Strong Excel Skills
  • Knowledge of Access and/or other Database Applications preferred.
  • Good written and verbal communication skills

EEOC Statement

We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.

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