Manager A/R - Ambulatory Surgery Center (ASC)

Job Description

Job Description

Description:

About Us

Carolina NeuroSurgery & Spine Associates (CNSA), established in 1940, is one of the largest and most highly respected neurosurgical private practices in the nation. As a physician-led, multi-site organization, we are recognized for clinical excellence and innovation in brain and spine care. Through our growing MSO, PracticeCore, and strategic partnerships, we are building a scalable, forward-thinking platform to support providers and deliver exceptional patient care. Position is on-site located in Charlotte, NC.

About the Role

This AR Manager – ASC owns the accounts receivable function for ambulatory surgery center (ASC) business, ensuring timely, accurate, and compliant collection of facility-side claims. This role is distinct from professional/physician billing AR: ASC reimbursement is driven by facility fee schedules, case-rate and bundled payer contracts, implant and device cost recovery, multiple-procedure payment reductions, and ASC-specific authorization and medical necessity requirements. The AR Manager – ASC is accountable for AR aging, net collection rate, and denial resolution specific to the facility claim stream, and works in close coordination with the ASC business office, coding, and managed care contracting to ensure facility reimbursement reflects the true cost and complexity of cases performed.

This role requires direct, demonstrated ASC revenue cycle experience – general physician billing AR background alone is not sufficient given the structural differences in how ASC claims are built, priced, and adjudicate.

Key Responsibilities:

• Own AR performance for the ASC facility claim stream — aging, net collection rate, cash application accuracy, and timely follow-up across all payer classes
• Lead denial management specific to ASC claims, including medical necessity denials, multiple-procedure payment reductions, implant/device-related denials, and bundling/unbundling disputes
• Manage and develop AR staff dedicated to ASC accounts, including productivity standards, quality audits, and coaching
• Partner with managed care contracting to ensure case-rate, per-diem, and bundled payment terms are being correctly applied and reimbursed
• Oversee implant and high-cost device billing and cost recovery, ensuring documentation and carve-out billing requirements are met per payer contract
• Validate facility fee schedule application and identify underpayment patterns relative to contracted rates
• Collaborate with the ASC business office (e.g., CCSS) on prior-authorization accuracy, case scheduling documentation, and charge capture completeness ahead of claim submission
• Identify and escalate systemic issues in ASC claim build, coding-to-billing handoff, or payer adjudication, and partner with Process Improvement on SOP development
• Monitor and report ASC-specific KPIs (days in AR, clean claim rate, denial rate by category, implant cost recovery rate) to RCM leadership
• Stay current on ASC-specific payer policy changes, CMS ASC payment system updates, and state ASC licensure/billing requirements
• Serve as the AR escalation point for high-dollar or complex ASC claims requiring payer appeal or peer-to-peer-adjacent resolution

You are a collaborative and accountable leader who knows how to balance day-to-day operational execution with a forward-looking mindset. You bring strong functional expertise and communicate clearly and effectively, building strong working relationships with physicians, leaders, and team members. You are an invested people leader who coaches and develops talent, sets clear expectations, and fosters a culture of accountability, quality, and continuous improvement. You are proactive in identifying challenges, raising issues, and working through solutions, ensuring that risks are addressed early and effectively. You are energized by solving problems, improving processes, and using data to guide decisions and drive team performance

If this sounds like you and you have the following qualification, the Manager, Account Receivable role may be a great fit:

• 2-5+ years of progressive billing management experience for a medical group, surgical specialty, or health system
• 3 years of Ambulatory Surgery Center billing and collections experience
• Strong working knowledge of ASC fee schedules, CMS ASC payment groupings, case-rate/bundled payer contracts, and multiple-procedure payment reduction rules
• Experience managing implant and device cost recovery and carve-out billing
• Deep expertise in billing, coding, reimbursement, and payer dynamics
• Demonstrated ability to design and implement scalable processes that improve efficiency and support growth
• Proven success leading and developing multi-site teams, with a focus on engagement, performance, and retention
• Experience with practice management/EHR systems supporting ASC billing workflows (e.g., Epic)
• Strong analytical skills with experience using data to inform strategy and decision-making
• Experience implementing process improvements, systems, or automation within the revenue cycle
• Bachelor’s degree in a relevant field, or equivalent combination of education and experience

Preferred Qualifications:

• ASC billing/coding certification (e.g., CASCC) or equivalent specialty credential
• Experience in a multi-specialty surgical ASC supporting neurosurgery, orthopedics, spine, or pain management procedures
• Experience negotiating or supporting managed care contract language related to ASC reimbursement
• Familiarity with NSA/IDR (No Surprises Act/Independent Dispute Resolution) processes as applied to out-of-network ASC claims
• Experience operating within a multi-entity or MSO ASC structure

Core Competencies:

• ASC-specific revenue cycle expertise
• Payer contract and fee schedule fluency
• Denial management and root-cause resolution
• Staff leadership and performance management
• Cross-functional collaboration (business office, coding, managed care contracting)
• Data-driven reporting and executive communication

Tools & Systems Exposure:

• Epic (ASC billing, claim edits, AR work queues)
• Payer portals and clearinghouses
• Managed care contract management tools
• Reporting/BI tools for AR and denial trend analysis