Corp Managed Svcs RCMS Senior Manager Hospital Billing, AR Calling Operate
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Posted on:
Yesterday
Vacancies:
1 Vacancy
Job Summary
Industry/Sector
Not ApplicableSpecialism
Managed ServicesManagement Level
Senior ManagerJob Description & Summary
At PwC our people in operations consulting specialise in providing consulting services on optimising operational efficiency and effectiveness. These individuals analyse client needs develop operational strategies and offer guidance and support to help clients streamline processes improve productivity and drive business performance.In operations and solutions at PwC you will focus on providing consulting services to optimise overall operational performance and develop innovative solutions. You will work closely with clients to analyse operational processes identify areas for improvement and develop strategies to enhance productivity quality and efficiency. Working in this area you will provide guidance on implementing technology solutions process automation and operational excellence frameworks.
Growing as a strategic advisor you leverage your influence expertise and network to deliver quality results. You motivate and coach others coming together to solve complex problems. As you increase in autonomy you apply sound judgment recognising when to take action and when to escalate. You are expected to solve through complexity ask thoughtful questions and clearly communicate how things fit together. Your ability to develop and sustain high performing diverse and inclusive teams and your commitment to excellence contributes to the success of our Firm.
Examples of the skills knowledge and experiences you need to lead and deliver value at this level include but are not limited to:
- Craft and convey clear impactful and engaging messages that tell a holistic story.
- Apply systems thinking to identify underlying problems and/or opportunities.
- Validate outcomes with clients share alternative perspectives and act on client feedback.
- Direct the team through complexity demonstrating composure through ambiguous challenging and uncertain situations.
- Deepen and evolve your expertise with a focus on staying relevant.
- Initiate open and honest coaching conversations at all levels.
- Make difficult decisions and take action to resolve issues hindering team effectiveness.
- Model and reinforce professional and technical standards (e.g. refer to specific PwC tax and audit guidance) the Firms code of conduct and independence requirements.
Job Descriptions Wolfe Project
Charge Entry / Biller
Responsibilities:
- Accurately enter charges into the practice management system.
- Review encounter forms operative notes and documentation for completeness.
- Apply correct CPT HCPCS and ICD-10 codes based on clinical documentation.
- Ensure billing compliance with specific guidelines and payer requirements.
- Submit clean claims to insurance carriers promptly to reduce denials.
- Coordinate with internal supervisors and coding staff for missing or unclear documentation.
Qualifications:
- 2 and above years of medical billing/charge entry experience.
- Knowledge of CPT HCPCS ICD-10 coding and payer billing rules.
- Familiarity with Medicare and commercial insurance billing.
- Strong attention to detail and accuracy.
- Flexible working in Shifts
Cash Poster / Credit Balance Specialist
Responsibilities:
- Post payments adjustments and denials from EOBs ERA and patient payments into the system.
- Reconcile daily deposits against bank statements.
- Identify and resolve credit balances in compliance with payer regulations.
- Process patient refunds and insurance overpayments timely.
- Collaborate with billing and AR teams to resolve discrepancies.
- Maintain accurate records for auditing and compliance.
Qualifications:
- 2 and above years of payment posting experience in healthcare.
- Knowledge of EOB/ERA interpretation billing workflows.
- Experience handling credit balances and refunds.
- Proficiency with billing software and Excel.
- Flexible working in Shifts
Denial Coder (Ophthalmology Specialty)
Responsibilities:
- Review denied ophthalmology claims and determine the root cause (coding documentation eligibility etc.).
- Correct and resubmit claims with accurate CPT/ICD-10 coding.
- Work with supervisors and coding staff to resolve documentation deficiencies.
- Prepare and submit appeals with supporting medical documentation.
- Track denial trends and recommend process improvements.
- Stay updated on payer policies and ophthalmology coding guidelines.
Qualifications:
- 3 and above years of medical coding experience (ophthalmology preferred).
- Certified Professional Coder (CPC) or equivalent strongly preferred.
- In-depth knowledge of ophthalmology-specific coding modifiers and LCD/NCD guidelines.
- Strong analytical and problem-solving skills.
- Flexible working in Shifts
Eligibility Verification Specialist
Responsibilities:
- Verify patient insurance eligibility and benefits prior to scheduled visits or procedures.
- Confirm coverage for exams diagnostic tests (OCT visual fields etc.) and surgical procedures.
- Document copays deductibles coinsurance and authorization requirements.
- Communicate insurance details to patients and front office staff.
- Work with insurance carriers to resolve eligibility issues.
- Maintain up-to-date records for compliance and billing accuracy.
Qualifications:
- 2 and above years of experience in medical eligibility verification.
- Familiarity with payer requirements.
- Strong communication and customer service skills.
- Ability to manage multiple verification requests in a timely manner.
- Flexible working in Shifts
Travel Requirements
Not SpecifiedJob Posting End Date
Required Experience:
Senior Manager
Key Skills
- Revenue Cycle Management
- Athenahealth
- ICD-10
- Management Experience
- Medical Coding
- ICD-9
- Medical Billing
- Budget management
- CPT Coding
- Leadership Experience
- Medicare
- Supervising Experience
About Company
At PwC, our purpose is to build trust in society and solve important problems. We’re a network of firms in 155 countries with over 284,000 people who are committed to delivering quality in assurance, advisory and tax services. Find out more and tell us what matters to you by vis ... View more
