Location: Remote
Reports To: Director of Revenue Cycle
Employment Type: Full-Time
Position Summary
The RCM Account Manager is responsible for managing all aspects of the revenue cycle for a cardiovascular-focused Ambulatory Surgery Center (ASC), including medical coding, billing, claims management, payment posting, and collections. This role ensures compliant, timely, and accurate reimbursement for cardiology and peripheral vascular procedures while providing high-touch service to internal stakeholders and physician partners.
Key Responsibilities
Coding & Charge Capture
- Accurately code cardiovascular procedures (e.g., peripheral interventions, pacemakers, stents) using CPT, HCPCS, and ICD-10 guidelines.
- Ensure documentation compliance with CMS and payer-specific policies.
- Stay current with cardiology-specific coding updates and NCCI edits.
Billing & Claims Management
- Submit clean claims to Medicare, commercial payers, and third-party administrators.
- Review and correct claim edits and denials related to cardiovascular services.
- Ensure timely billing of high-volume cases and effective charge lag management.
Collections & Payment Reconciliation
- Monitor accounts receivable (AR) with a focus on early intervention for unpaid cardiovascular claims.
- Post payments and contractual adjustments accurately.
- Communicate proactively with payers to resolve underpayments or denials.
Reporting & Analysis
- Track performance KPIs (days in AR, denial rates, net collections) specific to cardiovascular services.
- Provide regular revenue cycle updates to ASC leadership and physician partners.
- Identify trends in payer behavior, denials, or coding issues and recommend corrective action.
Compliance & Process Improvement
- Ensure compliance with AAAHC, Medicare, and commercial billing regulations.
- Participate in internal audits and implement corrective actions as needed.
- Contribute to SOP development for ASC cardiovascular billing best practices.
Qualifications
- 3+ years of experience in ASC or specialty medical billing (preferably in cardiology).
- CPC or CCS-P certification strongly preferred.
- Strong working knowledge of CMS ASC payment system and cardiovascular CPT codes (e.g., 92960, 93656, 33208).
- Experience with RCM software (e.g., Waystar, Surgical Information Systems (SIS), or equivalent).
- Excellent analytical, communication, and organizational skills.
- High level of professionalism and attention to detail.
Preferred Attributes
- Experience working with physician-owned or joint-venture ASCs.
- Familiarity with Medicare Local Coverage Determinations (LCDs) for cardiology.
- Track record of improving collections and reducing AR in a cardiovascular setting.