Position Title: Senior Manager, Surgical Revenue Cycle (General Surgery)
Location: San Antonio, TX (Medical Center District) | Hybrid Remote Options Available
Employment Status: Part Time / Full-Time, Exempt
Compensation: Hourly Reate $45 per hour. Benefits and Bonuses available.
Position Summary:
We are looking for a strategic partner As the Senior Manager of Surgical Revenue Cycle established private practice, you will serve as the architect of our financial health. You will act as the bridge between clinical excellence and financial viability, ensuring that over 50 years of surgical expertise is accurately translated into revenue. This role requires a rare combination of deep clinical coding knowledge (General Surgery), technical mastery of the TEBRA (Kareo) ecosystem, and the tenacious drive of a top-tier biller.
Core Mission:
To achieve 98% Clean Claim Rate and maximize compliant reimbursement through the expert application of General Surgery coding guidelines and the strategic utilization of TEBRA’s automation features.
Essential Duties & Responsibilities:
- Advanced Surgical Coding (CPC):
- Analyze and abstract complex General Surgery operative reports (Hernia, Gallbladder, Breast, Colon, Soft Tissue) to assign accurate CPT and ICD-10-CM codes.
- Mastery of the Global Surgical Package; expertly applying Modifiers 24, 25, 57, 58, 78, and 79 to differentiate billable services from bundled care.
- Conduct real-time Clinical Documentation Improvement (CDI) reviews, querying the surgeon to clarify documentation nuances (e.g., "Incarcerated" vs. "Reducible") that impact revenue and risk adjustment.
- Revenue Cycle Management (CPB):
- Oversee the full lifecycle of the claim within TEBRA EMR, from charge entry to zero balance.
- Manage the "Robotic Process Automation" (RPA) workflows for eligibility verification and claim scrubbing; resolve exceptions and edit rules engines to prevent future errors.
- Aggressively manage the Accounts Receivable (A/R) inventory. Investigate denials, identify root causes (e.g., NCCI edits, LCD restrictions), and draft evidence-based appeals.
- Manage patient financial relations with empathy; oversee the "Patient Collect" digital statement process and negotiate payment plans for self-pay patients.
- Practice Optimization & Compliance:
- Maintain the practice’s fee schedule in alignment with 2026 Medicare and commercial allowable rates.
- Ensure strict adherence to HIPAA and OIG compliance standards regarding billing practices.
- Provide monthly financial reports , translating data (DSO, Net Collection Ratio) into actionable business intelligence.
Qualifications & Competencies:
- Certifications:
- Required: CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist - Physician).
- Preferred: CPB (Certified Professional Biller) or CBCS (Certified Billing and Coding Specialist).
- Experience:
- Minimum 5 years of medical coding and billing experience.
- Mandatory: At least 3 years of demonstrable experience in General Surgery or a high-volume surgical subspecialty.
- Mandatory: Proven "Super User" proficiency with TEBRA (Kareo) EMR/PM software.
- Technical Skills:
- Deep knowledge of Texas-specific payer rules (BCBS TX, Novitas Medicare, Texas Medicaid).
- Ability to navigate NCCI edits, MUEs (Medically Unlikely Edits), and LCD/NCD policies.
- Soft Skills:
- Physician Liaison: Confidence to educate and collaborate with a senior surgeon regarding documentation requirements.
- Autonomous Leadership: Ability to self-direct work, manage priorities, and solve problems without micromanagement.
Benefits & Culture:
- Competitive Salary with performance incentives based on collection targets.
- 100% Employer-Paid Health Insurance Premiums for the employee.
- Paid Time Off (PTO) and Holidays.
- Professional Development Support (AAPC Dues & CEU credits paid).
- Direct access to practice leadership; a culture of respect, autonomy, and professional impact.