Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has an exceptional track record of generating the very best outcomes for patients, payers, and providers. Deep clinical expertise is the foundation for every part of Paradigm’s business: risk-based clinical solutions, case management, specialty networks, home health, shared decision support, and payment integrity programs.
We’re proud to be recognized—again! For the fourth year in a row, we’ve been certified by Great Place to Work®, and for the third consecutive year, we’ve earned a spot on Fortune’s Best Workplaces in Health Care™ list. These honors reflect our unwavering commitment to fostering a positive, inclusive, and employee-centric culture where people thrive.
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The Revenue Cycle Manager (RCM) is responsible for all activities related to collections, cash application, and provider payments of the division’s five products. The RCM is responsible for ensuring the cash conversion cycle is optimized and key cash flow metrics are maintained. The RCM will manage a staff of Accounts Receivable Analysts and Collectors as well as have in depth knowledge of issues across client accounts. On the accounts payable side, the Revenue Cycle Manager will ensure timely payment of providers as well as settle pay discrepancy issues.
The RCM must effectively interface with and collaborate with several key partner departments (Account Mgmt., Operations, and Provider Services) as well as within Finance (Accounting).

QUALIFICATION REQUIREMENTS:

• 5 years of applicable work experience as a leader in healthcare financial operations or revenue cycle departments with proven success in Finance or Collections.
• Workers’ compensation or applicable healthcare experience is required.
• Supervision of staff; development.
• Analytical/problem solving skills.
• Attention to detail.
• Account reconciliation.
• Accurate and comprehensive reporting.
• Excellent communication, both verbal and written.
• Understanding of Accounts Receivable and Collections, in a business-to-business environment.
• Strong attention to detail, goal oriented, superb critical thinking skills.
• Knowledge of medical billing and medical collection procedures.
• Proven success in reducing DSO and collections.
• Ability to prioritize and manage multiple responsibilities in a fast-paced environment.
• Technical Capacity including advanced knowledge of Microsoft Office, specifically Excel and Access.

DUTIES AND RESPONSIBILITIES:

• Manage staff of cash applications, AR analysts, and collectors, assuring department is staffed appropriate to the needs of the division and that staff is performing their duties effectively.
• Ability to process and organize facts, data, and other information to define a problem and develop effective solutions.
• Make decisions and solve problems using sound reasoning and judgement.
• Responsible for process improvement initiatives related to revenue cycle activities to maximize the performance and integrity of the revenue cycle process.
• Analyze, troubleshoot, and measure performance for processes and workflow affecting the overall revenue cycle.
• Works closely with other department supervisors/coordinators to ensure proper billing practices (coding, pricing, adjustments, client communications, etc.) impacting collections.
• Monitors aged accounts and verifies appropriate collections procedures are being followed.
• Resolves escalated reimbursement issues with Payers and systems for optimal management of accounts receivable.
• Interacts with clients to ensure proper protocols and processes are being adhered to by all parties.
• Manages AR operations; design & implement necessary job guides, workflows, policies, practices, and procedures related to revenue cycle initiatives.
• Regularly provides upper management with revenue cycle status including reports, metrics, and presentations.
• Participates in weekly, monthly, and quarterly meetings with management as it relates to delinquent A/R review calls and revenue meetings with clients.
• Preparing relevant information, analysis, and suggestions; tracking action items from the meetings and follow up.
• Ensure collections are being managed properly and efficiently and determining appropriate corrective action to take when confronted with accounts receivable discrepancies while taking initiative to assure that corrective action is completed.
• Serves as a leader, resolving both internal and external customer issues within an appropriate time frame.
• Showing persistence and seeking alternatives when challenges arise.
• Maintains a current understanding and working knowledge of Workers Compensation and contracts for programs and networks which PSN is actively participating in.
• Performs other duties as needed / assigned.
• Responsible for complying with Paradigm IT security requirement and policies.
• Responsible for safeguarding Paradigm or Paradigm related IT passwords.
• Responsible for notifying Paradigm of any IT security incidents per Policy No. 16.0 Information Security Incident Management.

SUPERVISORY RESPONSIBILITIES:

• Mentor, train, and supervise team members directly and indirectly, review their work and provide effective constructive feedback.
• Ensure all team members understand, are trained in, and comply with Paradigm’s security requirements and policies.
• Ensure all team members have the minimum level of IT system access required to effectively complete their Paradigm responsibilities.