JOB TITLE: Revenue Cycle Management Director
REPORTS TO: Practice Administrator
DEPARTMENT: Administration
STATUS: Full-time, 40 hours per week, Exempt, 100% FTE
POSITION SUMMARY
The Director of Revenue Cycle Management is accountable for ensuring the consistency and quality of the coordination of revenue cycle operations, procedures, and best practices for charge capture, billing, payment posting, collections and follow-up, denials management, billing audits, and revenue cycle data reporting for all entities. This position is responsible for overseeing a strong team of medical billers. This position requires current, in-depth knowledge of governmental and commercial insurance rules and regulations, including regulatory compliance requirements.
DUTIES & RESPONSIBILITIES
1. Responsible for ensuring all RCM functions (billing, collections, cash management, reporting, and credentialing) operate efficiently and effectively.
2. Responsible for managing a strong team of managers, leads, and medical billers. Understands the job functions of all Revenue Cycle staff, is aware of process flow across departments, and involves them, as appropriate, when recommended actions may impact their work functions.
3. Hold regular, weekly & monthly meetings with departmental supervisors and keep them abreast of important issues related to revenue cycle operations.
4. Continually seeks ways and means for improving the delivery and support of revenue cycle activities and programs including monitoring the routine development of training material and ensuring educational resources to current and future staff.
5. Develop policies and procedures for all points of the revenue cycle including, but not limited to, charge capture, data entry, payment posting, insurance follow-up, collections, and denials management.
6. Develop and implement evaluation tools and measure staff efficiency and effectiveness.
7. Creates an environment of continued improvement and innovation.
8. Monitors and adheres to applicable Federal, State, and local laws and regulations as well as other policies and procedures.
9. In collaboration with managers and leaders, monitor the payments of third-party payers to assess compliance with established contracts. Troubleshoot problems associated with missed or unbilled charges, payment delays, denials, and other revenue cycle issues.
10. Develop an expansion plan for adding capacity to handle rapid growth.
11. Review the practice's results monthly to discuss the performance.
12. Participate and provide input in monthly bad debt reviews of facilities with the finance team.
13. Create a training manual for revenue cycle management process for use by the billing staff.
14. Performs enrollment for electronic billing, funds, and remittances for facilities.
15. Participates in quarterly aging review with those facilities not meeting company standards.
16. Provides ongoing support and training to the billing and front office staff in the areas of revenue cycle management.
17. Provides ongoing support and training on all aspects of billing, claims, banking, accounting and EHR software.
18. Provides ongoing support and training on eligibility and authorization processes for all payer types, such as Medicaid, Medicare, Managed Care, etc.
19. Provides direction on the follow-up process for all payers, including claim correction and appeals
20. Provides direction on the collection process for private accounts, including small claims court, collection agencies, and attorney referrals
21. Assists the facility with implementing and improving systems.
22. Conducts monthly and quarterly audits.
23. Review and reconcile the month-end close process with each facility to ensure accurate revenue.
24. Maintains facility and user setup in EHR and software applications.
25. Develops Billing Office supervisory skills and assists them with performance and development of the billing department.
26. Assists the facility in the development and achievement of goals.
27. Oversees management in obtaining and maintaining payer contracts and contract negotiations.
28. Assists with credentialing and onboarding of new providers.
29. Assists in the recruitment and selection of billing staff and billing department positions.
30. Employee Safety: Safely performs all duties; follows required protective protocols to ensure personal safety as well as the safety of others.
31. Must maintain compliance with ergonomic safety standards; be mindful of posture and regularly practice ergonomic stretches.
32. Safety: Responsible for ensuring that all duties, responsibilities, and operations are performed with the utmost regard for the safety and health of all personnel involved, including themselves.
33. Safety: Take appropriate corrective actions to address matters pertaining to employee health and safety that have been brought to their attention.
34. Other duties as assigned by the Practice Administrator.
33. In coordination with the Administration team, prepare and analyze the annual development plan with the corresponding budget, outlining revenue and expense; monitor progress against goals and produce monthly reports.
34. Directing management in the implementation of strategies.
35. Supervising managers throughout time-sensitive projects.
MINIMUM QUALIFICATIONS
1. Bachelor’s degree in health administration or related field or minimum of five years progressive related experience; or equivalent combination of education and experience.
2. At least 5 years of experience within the healthcare revenue cycle industry, including but not limited to physician practice, health system, biomedical, pharmaceutical, or similar. Experience within the areas of insurance verification, benefits investigations, and reimbursement, cash management, payment posting, denials management, healthcare technology, billing, coding, customer service, counseling, teaching/education, customer-facing or back office, or experience with associated online payer systems.
3. Extensive knowledge of Medicare, Medicaid, and Managed Care is required.
4. Strong computer skills with knowledge of various EHR systems.
5. Strong analytical skills with the ability to identify trends and present information in a succinct and actionable manner.
6. Powerful leadership skills with the ability to coach and mentor teams through periods of high growth.
7. Creative problem-solving skills with the ability to multi-task and prioritize business requirements in a dynamic, fast-paced environment.
8. Ability to think and work creatively and effectively in a rapidly changing environment.
9. Exceptional customer service orientation focusing on collaboration and flexibility when working with external and internal stakeholders.
10. Must have the ability to relate and communicate effectively with community interest groups, agencies, and medical facilities.
Job Type: Full-time
Pay: From $25.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Healthcare setting:
Schedule:
- 8 hour shift
- Monday to Friday
Ability to Commute:
Work Location: In person