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BILLINGS AND COLLECTIONS REGIONAL MANAGER - REMOTE, FULL TIME

OUR VISION & VALUES
At Blue Cloud, it's our vision to be the leader in safety and quality for pediatric dental patients treated in a surgery center environment. Our core values drive the decisions of our talented team every day and serve as a guiding direction toward that vision.
1. We cheerfully work hard
2. We are individually empathetic
3. We keep our commitments

The CBO Regional Manager, Billing and Collections Operations is a revenue cycle management (RCM) leadership position responsible for the day-to-day management of the billing and accounts receivable (A/R) processes for a defined Blue Clue region of facilities. This role focuses on maximizing revenue and payment capture by ensuring accurate, timely claim submission, aggressive payer follow-up for payor and patient payment issues, and effective denial management to identify and mitigate denial root causes. The Regional Manager will lead and grow a comprehensive billing and collections team, implement best practices, and work closely with the other region-based teams, vendors, facility operators and internal stake holders to optimize RCM performance.

YOU WILLEssential Functions (Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions).
• Strategic Leadership: Manage billing and collection strategies, policies, and procedures to achieve best-in-class RCM performance (e.g., cash to net revenue, DNFB, A/R days, clean claim rate, denial rate, etc.).
• Operational Oversight: Manage the day-to-day operations of a region-based billing and collections team, ensuring daily operations are efficient, compliant, and meeting performance targets.
• Insurance & Payer Relations: Work closely with internal payer relations and insurance payer representatives to ensure proper contracted rates are captured and billed appropriately by responsible RCM teams.
• Compliance & Auditing: Ensure Blue Cloud is capturing revenue and billing in adherence to federal, state, and payer-specific regulations and lead internal audits to maintain compliance. Adheres to and reinforces coding, billing, collections and payment posting internal controls and auditing protocols to optimize net revenue capture and reimbursement in a compliant manner.
• Performance, Reporting, & Analytics: Manage and provide recurring quantified detail for key revenue cycle performance and staff productivity metrics, key performance indicators, and productivity standards and create data visualization and reporting to highlight opportunities, variance and risk and optimize team performance.
• Process Improvement: Identify areas for improvement and implement solutions for revenue cycle operations functions and payment variance workflows, reporting, and data visualization, and implement best practices to improve efficiency and performance and scale to support continued platform and volume growth.
• Team Development: Recruit, train, mentor, and manage a multi-disciplinary, multi-specialty team to perform and oversee billing and collections processes for all Blue Cloud facilities. Provide continuing education and professional development to maximize retention and career progression of team members and leaders.
• Growth Partnership: Aid executive leadership and development teams with revenue modeling, sensitivity analysis, and forecasting to optimize growth strategy, pro forma accuracy, and ROI for all de novo and M&A activity

YOU HAVE

Education: Bachelor's degree in Business Administration, Healthcare Administration, Finance, or a related field (Master's preferred).

Experience: Minimum of 5 years of experience in healthcare billing and collections, with at least 2 years in a supervisory or management role, preferably within a surgical or ASC environment. Dental/Oral Surgery experience is a significant plus.

Certifications: HFMA's Certified Revenue Cycle Representative (CRCR), Certified Professional Biller (CPB), or Certified Professional Coder (CPC) preferred.

Skills:

Strong knowledge of ASC coding, billing and reimbursement methodologies.
Demonstrated expertise in dental and multi-specialty is preferred.
Demonstrated utilization and optimization of workflows, functionality and reporting in EMR and PAS solutions (e.g., Epic, Cerner, Allscripts, HST Pathways, SIS Complete).

Experience using Open Dental is a plus. Additionally, experience utilizing and optimizing clearinghouse solutions (e.g., Availity) is preferred.

Proficiency in Microsoft Excel, Power BI, and data analysis tools and demonstrated ability to develop executive-facing work products that outline performance, risk, and opportunities to optimize revenue and payment capture.

Excellent problem-solving, leadership, and communication skills.
Ability to manage multiple priorities in a fast-paced environment.

Compliance & Company Policies

- Must maintain strict confidentiality in accordance with HIPAA and company policies.
- Ensure all revenue cycle activities align with federal and state compliance regulations

BENEFITS

Work with a passionate, dedicated, and talented team in a growing organization committed to doing good
Health insurance, Flexible Spending and Health Savings Accounts, disability coverage and additional voluntary plans
401k plan, including company match
Paid Time Off
No on call, no holidays, no weekends

This is a remote position with opportunity available in Arizona, Texas, Delaware, Idaho, West Virginia, Kansas, Maryland, Michigan, Nevada, North Carolina, Penn, Tennessee, Missouri

Other DutiesPlease note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the associate for this job. Duties, responsibilities and activities may change at any time with or without notice.

Physical DemandsThe physical demands described here are representative of those that must be met by an associate to successfully perform the essential functions of this job. While performing the duties of this job, the associate is regularly required to talk and hear. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. This position requires intermittent physical activity, including standing, walking, bending, kneeling, stooping and crouching as well as lifting.

Blue Cloud is an equal opportunity employer. Consistent with applicable law, all qualified applicants will receive consideration for employment without regard to age, ancestry, citizenship, color, family or medical care leave, gender identity or expression, genetic information, immigration status, marital status, medical condition, national origin, physical or mental disability, political affiliation, protected veteran or military status, race, ethnicity, religion, sex (including pregnancy), sexual orientation, or any other characteristic protected by applicable local laws, regulations and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application process, read more about requesting accommodations.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

Blue Cloud Pediatric Surgery Centers LLC jobs

Billing and Collections Regional Manager - Remote