About the Role

OpenLoop is looking for a Senior Revenue Cycle Manager to join our HQ team in Des Moines, IA (onsite - hybrid). The Senior Revenue Cycle Manager will play a key role in allowing us to attract and retain new Revenue Cycle Management (RCM) partners, as well as take on more volume from current partners by enhancing revenue performance, integrity, and compliance. This role involves developing and implementing strategies to improve financial performance, and collaborating with other departments to streamline processes.

What You'll Do

• Manage various teams to execute departmental standard operating procedures, standard of work, and service line agreements
• Oversight of prior authorization and eligibility, billing, coding, denials/appeals, and collections
• Establish a comprehensive education and auditing program to ensure legal compliance, program integrity and proper reimbursement
• Monitor KPI’s against industry benchmarks, staff productivity and adjust as necessary to meet business goals and objectives
• Manage escalation process to identify trends and aid in driving resolutions including, team members, payer challenges, platforms or processes for escalated issues
• Collaborate cross-functionally to lead rejection and denial management program to identify opportunities to improve payer outcomes and maximize reimbursement coverage for patients
• Assist with the identification and implementation of technology enhancements to improve department efficiencies
• Other duties as assigned

Who You Are

• 5+ years in relevant healthcare and RCM leadership experience
• Bachelor’s degree or equivalent experience required
• Certified Professional Coder (CPC) preferred with strong understanding of CPT & ICD-10-CM
• Ability to demonstrate strong strategic thinking, collaboration, leadership, problem solving and communication skills with internal and external stakeholders
• Strong reimbursement knowledge and understanding of telehealth, Medicaid Medicare, Medicare Advantage, Government and Commercial payers guidelines
• Preferred experience with provider enrollment and credentialing