Revenue Cycle Support/project Manager

Revenue Cycle Support/Project Manager

The Revenue Cycle Support/Project Manager is responsible for accurate payer and contractual allowance setup across multiple billing systems, ensuring correct rate and claim presentation, and coordinating EDI enrollments. Key duties include managing month-end close procedures, analyzing data for anomalies, problem-solving system issues, supervising direct reports, and maintaining partnerships across departments. This role assists and tracks EDI enrollments, is a Subject Matter Expert, and will provide training as needed.

Responsibilities:

• Accurate payer setup in multiple billing system(s): Confirm correct rate and claim presentation Confirm success of transmissions upon initial setup
• Accurate contractual allowance setup in multiple billing system(s)
• Accurate calculation of expected reimbursement
• Setup of new sites within Revenue Cycle Platforms
• Proactively work acquisitions to avoid as many disruptions as possible
• Work with EDI staff to ensure all eligible electronic options are enabled/utilized
• Perform Month-End Close Procedures/Processes: Report variances
• Review systems for non-admits or duplicate admissions
• Problem solving system issues, identifying root cause and next steps
• Portal Admin/access
• WayStar setups and payer matching
• Partner with Operations, as needed, to identify work through issues
• Analyze data for anomalies
• Supervise work of direct reports
• Maintain excellent partnerships with multiple lines of business and departments
• Coordinate to identify changes for governmental payors
• Monitor for variances and facilitate research

Qualifications:

• Degree, BBA or BS in Accounting, Finance or Business preferred or equivalent work experience.
• 3+ years of relevant experience preferred.
• CompTIA Project Certification preferred.
• Excellent verbal, analytical and interpersonal skills.
• Intermediate level of Excel knowledge required for optimal functionality in the role.
• Proficiency in Microsoft office suite.
• An ideal candidate for this position can approach problem-solving challenges independently, have strong attention to detail, enjoy working in a fast-paced, collaborative and team-based objectives.
• Ability to understand payer contracts and translate information into payer setup for multiple systems.
• Must have the ability to analyze information and share findings.
• Ability to work with multiple teams to ensure collaboration and effective communication.
• Ensure compliance with corporate policies.
• Travel up to 25%

About our Line of Business:

BrightSpring Health Services provides complementary home- and community-based pharmacy and provider health solutions for complex populations in need of specialized and/or chronic care. Through the Company's service lines, including pharmacy, home health care and primary care, and rehabilitation and behavioral health, we provide comprehensive and more integrated care and clinical solutions in all 50 states to over 450,000 customers, clients and patients daily. BrightSpring has consistently demonstrated strong and often industry-leading quality metrics across its services lines while improving the quality of life and health for high-need individuals and reducing overall costs to the healthcare system.