Manager, RCM Services

Sandata Technologies is the leading supplier of software technology solutions serving home care and I/DD agencies, managed care organizations, and state payer programs throughout the United States. The Sandata solution has been implemented by 15,000 Provider Agencies, 18 State Payers, and 50 MCO Payers to ensure their compliance with changes in regulatory/compliance requirements and ongoing complexities. We make it easier for these organizations to work together and to manage their businesses while also getting paid as quickly as possible.

At Sandata, we are committed to creating a real and measurable Diversity, Equity, and Inclusion initiative. We will create a work culture where we are curious, celebrate, respect, and appreciate our unique diverse stories, and how we've come to where we are. We will do everything possible so that people know that we care about them as an individual and work to build equity in our people, systems, and processes. We are continuing to grow our efforts, and we will grow further together.

Duties:

• Expand opportunity for Sandata RCM in the home care and IDD provider community
• Support Provider Sales team to promote the RCM offering to prospective customers
• Support Sales and RCM Operations management through customer onboarding process and subsequent follow up
• Provide customer proposal, contracting, and negotiation support by recommending SOW components, providing analysis, pricing input, etc.
• Create promotional content through thought leadership, webinars, conference presentations, blogs, social media posts, KPI analysis and tools development, market intelligence, customer testimonials, etc.
• Create, update, maintain, and execute RCM business plan
• Maintain RCM pipeline and close-won reporting
• Provide input for pricing, service and contract models
• Oversee and manage entire revenue cycle including billing, coding, collections, and denial management
• Manage relationships with external vendors for practice management software and clearinghouse vendor
• Communicate professionally with various payers and projects.
• Manage, develop, and mentor all revenue department staff, including billers and coders
• Oversee the admission process and manage the admissions team
• Responsible for management and maintenance of billing and practice management software platform
• Provide up to date education for clinical, billing, and coding staff on coding trends
• Develops, evaluates, implements, and revises policies and procedures related to billing, coding, reimbursement activities and improvement strategies
• Reconcile all receivables and revenue reports and work closely with the finance department in the development of the monthly financial statements
• Manage and update the rates in the designated system related to the agency.
• Review and resolve issues related to claim generation and rejected/denied billings.
• Keeps abreast of all reimbursement billing procedures of third party and private insurance payers and government regulations.
• Maintains appropriate internal controls over accounts receivable, RCM process
• Monitors accounts sent for collection and reimbursements from insurance companies and other third-party payers
• Reviews, monitors, and evaluates third party reimbursement and research variances
• Participates in the development of coding and billing strategies, evaluating process relative to revenue cycle.

Skills/Qualifications

• 3 years experience in health care billing with knowledge of the use of procedure codes and authorizations, preferably for home healthcare in a Medicaid MCO payer environment
• 3 years experience in payroll processing, computation, and compliance with regulations
• Ability to plan appropriately to meet specific processing deadlines
• Ability to communicate appropriately and develop relationships internally and externally
• Knowledge of Microsoft Office applications - Outlook, Excel, Word
• Knowledge of, or ability to learn and operate, Sandata Agency Management applications and processes
• Twenty percent Travel is required.
• Must have EVV and HHA eXchange experience

Perks and Benefits:

• Medical, dental, and vision coverage
• Flexible Spending Account for health and dependent care
• Health Savings Account
• BenefitsVIP/Health Advocate
• Company paid Life insurance and STD
• 401(k) Plan
• Aflac STD, LTD, Critical Illness, Hospital, and Accident insurance
• Employee Assistance Program
• Tuition reimbursement & paid certification programs
• In-house product training programs
• Catalog of training courses for skills development
• Career Pathing for every department
• Employee Resource Groups (BIPOC, LGBTQ, Women, Military Veterans)
• Paid vacation, sick days, and holidays
• Paid lunch break
• Employee discounts and company perks
• Casual work environment
• Remote work
• Frequent employee events and fun social clubs

Sandata Technologies is an Equal Opportunity Employer M/F/Disabled/Vet