Director of Revenue Cycle

Community Healthcare Center is seeking a full-time detail-oriented Director of Revenue Cycle. The perfect candidate will direct and oversee the overall policies, objectives, and initiatives of an organization's revenue cycle department. They will review, design, and implement processes surrounding onboarding, billing, third-party payer relationships, compliance, collections, and other financial analyses to ensure that clinical revenue cycle is effective and properly utilized. They will track metrics to develop sound revenue cycle analysis and reporting. They will track numerous metrics to develop sound revenue cycle analysis and reporting. Manage relations with payers and providers to endeavor to insure proper revenue capture and a low level of denials. Review new and renewing payor contracts and presents recommendations to the Chief Financial Officer for execution.

The Revenue Cycle Manager’s duties and responsibilities are:

• Directs daily Revenue Cycle operations, including but not limited to training, cash posting, billing, reverification of benefits, etc.
• Creates, runs, and monitors reports tracking operational and financial metrics by department staff.
• Assists internal work teams with workflow and work distribution; monitoring and maintaining compliance and performance standards by ensuring production and quality standards are met.
• Assists with development and implementation of department and project action plans.
• Train, mentor and resolve revenue cycle process related questions for team.
• Ensure the quality of each team members claim resolution activity.
• Advises of performance deficiencies; makes recommendations for retraining of employees.
• Assists in identifying and coordinating process improvement opportunities within the organization.
• Updates management with system and procedural issues which require analysis and resolution and compiles production reports for work group.
• Works with coders, practice managers and other staff as needed to resolve errors and release corrected claims.
• Monitors assignments in the electronic billing system to assure resolution of errors and edits.
• Processes billing interfaces and/or interface edits; identifies and resolves problems as they arise; reviews and corrects claim edits and denials to ensure proper payment for services rendered.
• Researches and distributes correspondence from insurance carriers to affected departments and ensures resolution for claims.
• Investigate patient account questions, assists Coders, Posters, Contracting, Front desk and Practice Managers as needed.
• Completes special projects that may require defining problems, determining work sequence and summarizing findings.
• Identifies problems and inconsistencies with federal, state, and private payer claims, and patient charges utilizing various reports; researches problems, summarizes findings and makes recommendations.

Associate or bachelor’s degree in a related field from an accredited college or university highly preferred. Requires at least 10 years of experience in an independent or group medical practice setting, with the last 5 years directly related to medical claims/revenue cycle process management. Previous FQHC experience highly preferred. A higher degree from an accredited institution may be substituted for experience on a year-for-year basis, up to two years.

Must maintain HIPAA/HITECH compliance and ensure confidentiality of any Private Health Information (PHI) or Electronic Private Health Information (ePHI).

Bilingual strongly preferred, but not required. Competitive salary and benefits package.

Job Type: Full-time

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Application Question(s):

• Do you certify that you are NOT a user of tobacco or nicotine products?
• Upon offer of employment, would you be willing to submit to a national background check?
• CHC is a drug-free workplace. Upon offer of employment, would you be willing to submit to a drug screen?

Experience:

• independent or group medical practice setting: 10 years (Preferred)
• directly related to medical claims/revenue cycle process: 5 years (Preferred)

Work Location: In person