The posting
Empowering Wellness, Transforming Lives
Optima Medical Management Group is dedicated to enhancing the quality of life by promoting wellness. At Optima MMG and all of its divisions: Serene Health, Community Support, and American TrueCare, our mission is to provide comprehensive support and care that not only addresses immediate concerns but also fosters long-term well-being.
As pioneers in the field, we aspire to lead in member care outcomes and set new standards for excellence and innovation. We are committed to empowering our members to achieve self-sufficiency in health, creating a ripple effect that strengthens families and communities.
Our work culture at Optima MMG is built on pride, passion, and a collective commitment to making a positive difference in people's lives. Our team members are dedicated problem-solvers who bring their unique skills and perspectives to the table. We believe that by fostering a collaborative and supportive environment, we can unlock the full potential of our team and, in turn, provide the best possible care to our members.
A career at Optima MMG is an opportunity to be part of a dynamic and forward-thinking organization. We encourage continuous learning and professional growth, providing our employees with access to industry experts, cutting-edge technologies, and a supportive community that values each individual's contributions. Join us on this journey to not only advance your career but to be a driving force in transforming lives and communities through passionate and fulfilling work!
Job Summary:
The Revenue Cycle Supervisor is responsible for leading the daily operations of the billing department ensuring accurate billing, denial and appeal reviews, and regulatory compliance. The supervisor reports to the Financial Controller and works collaboratively to evaluate department and organizational performance, evaluate optimizations, and translation of strategy into execution.
Supervisory Responsibilities:
- Lead revenue cycle staff to achieve operational and performance goals.
- Establish clear performance expectations and conduct regular evaluations.
- Foster collaboration across departments including accounting and procurement.
Duties/Responsibilities:
- Oversee daily execution of the billing, accounts receivable, denials management, patient collections and release of information.
- Ensure clean claim submission, timely follow-up, and optimal cash flow performance.
- Monitor workflow effectiveness and identify opportunities to streamline processes and reduce revenue leakage.
- Act as primary escalation point for daily revenue cycle operations support.
- Collaborate with front-end teams to improve operations and reduce preventable denials.
- Ensure coding processes are followed to ensure accuracy, completeness, and compliance with regulatory and payer requirements.
- Manage claim submission processes, edits, and work queues to maximize first-pass yield.
- Analyze denial trends, identify root causes, and implement corrective action plans.
- Monitor payer reimbursement accuracy against contract terms and fee schedules.
- Support payer contract modeling, variance analysis, and underpayment appeals.
- Partner with contracting and finance teams to improve net revenue performance.
- Optimize processes and standard operating procedures to support best practices and standardization.
- Perform other duties as assigned.
Education and Experience:
- Bachelor’s degree in Business Administration, Healthcare Administration, or a related field required.
- Prior supervisory experience highly preferred.
Skills and Abilities:
- Demonstrated knowledge of medical billing, coding, claims, collections processes and strategy, reimbursement methodologies, and payer processes required.
- Advanced analytical skills with the ability to interpret financial and operational data required.
- Excellent communication, leadership, and problem-solving skills required.
- Three (3) years of current experience for revenue cycle management environment preferred.
- Professional certifications such as CRCR, CPC, CPB, or related Epic certifications in revenue cycle preferred.
- Experience Medi-Cal and Managed Care billing preferred.
- Experience with capitated payment models and fee-for-service billing preferred.
- Experience working with Waystar strongly preferred.
Physical Requirements:
- Prolonged periods sitting at a desk and working on a computer.
- Must be able to lift up to 15 pounds at times.
Pay range
$28.85—$34.62 USD
Benefits
Our full-time employees are eligible for the following benefits enrollment after 60 days of employment:
Medical, Dental, & Vision Benefits: We have various insurance options for you and your family.
Short & Long-Term Disability Benefits: Protection when you need it most.
Voluntary Accident, Voluntary Critical Illness, and Voluntary Hospital Indemnity Plans: Added security for you and your loved ones.
Flexible Spending Accounts: Manage your finances with flexibility.
Employee Assistance Program (EAP): Support when life throws challenges your way.
401(K): Building your financial future with us. Effective after 1 year of employment.
Paid Vacation and Sick Leave: Flexibility for the planned and unplanned.
Paid Holidays: Quality time to enjoy celebrations.
Employee Referral Program: Share the opportunities and reap the rewards.
Company Discount Program: Enjoy savings on everyday expenses and memberships.
Equal Employment Opportunity
Optima Medical Management Group and its divisions are an Equal Opportunity Employer. Optima MMG is committed to providing employment opportunities for all qualified candidates without discrimination on the basis of race, religion, sex, sexual orientation, gender identity, age, national origin, citizenship, disability, marital status, veteran status, or any other characteristic protected by federal, state or local laws. Optima MMG is committed to providing reasonable accommodation for individuals with disabilities.
Pre-Employment
Optima Medical Management Group is a drug-free workplace. Employment is contingent upon a successful pre-employment drug screening and background check.
