Director Revenue Cycle Management

Description

The Director of Revenue Cycle is responsible for the direction and leadership of Revenue Cycle operational, financial, programmatic and personnel activities including claims, payments, credit balance, insurance reimbursement, and patient collections. This position reports to the Chief Financial Officer and works closely with the AVP of Payor Relations. The position’s major responsibility is directing the day-to-day operations, budgeting, financial management, and human resource management of ACP’s revenue cycle function. This includes setting organizational and strategic direction to drive efficient, accurate and compliant revenue cycle management billing and collection activities to maximize reimbursement across ACP’s insurance funded division. The Director of RCM will implement best practices across ACP’s five state service area, working externally with multiple commercial and Medicaid payors and internally supporting enterprise-wide initiatives that support ACP’s compliance, systems redesign, improved revenue, and/or reduced cost.

Essential Functions

• Regular and reliable attendance is an essential function of this position.
• Manage team responsible for the billing, collections, and payment posting assuring accuracy and efficiency in processes.
• Lead the development and implementation of revenue cycle strategies, processes, documentation, and improvement initiatives to continuously improve the RCM process to maximize ACP’s billings and collections.
• Ensure compliance in all aspects of RCM activities including coding and billing rules and regulations by payer and state. Responsible for monitoring and responding to any legislation/regulatory billing changes.
• Identify, document and implement strategies to reduce denied claims
• Develop and manage the Revenue Cycle budget – work with Finance to ensure assumptions used in budgeting and modeling are accurate.
• Manage Payor audits in conjunction with company compliance.
• Design, operationalize, monitor and report to leadership on key revenue cycle performance metrics.
• Collaborate with payers to understand coding and billing requirements and resolve issues, as needed.
• Meet regularly with clinical teams to present billing and collections data, develop solutions to streamline billing, reduce front end edits, and increase collections by clinical disciplines.
• Work closely with Analytics and Payment Integrity departments to review accuracy of fee schedules and billing.
• Work closely with ACP Controller to report on receivables to support cash flow analyses.
• Manage patient collections process and ensure ACP is collecting patient responsibility.
• Ensure all company, federal, state, local, and other applicable compliance requirements are met.
  
  

Competencies

• Data and deadline-driven mindset with excellent time management and prioritization skills.
• Outstanding verbal and written communication skills with the ability to create, communicate, influence, and direct a team to achieve the company’s vision and success
• Highly disciplined and organized, both operationally and in thought process
• Innovative, proactive, strong analytical and problem-solving skills.
• Experience managing both up, down, and across the organization
• Strong emotional intelligence and passion for building relationships across all levels of an organization
  
  

Meeting Expectations

• Weekly with CFO
• Weekly with RCM direct reports
• Monthly company-wide leadership team meeting
  
  

Supervisory Responsibilities

Manage RCM team.

Work Environment

This position operates in a hybrid office environment.

Physical Demands

• Prolonged periods sitting at a desk and working on a computer.
  
  

Travel Required

Some occasional travel required.

Education and Experience

• Bachelor’s degree in business, accounting, finance or equivalent related experience.
• 5 years of experience in a health care revenue cycle management role – provider RCM experience preferred
• Demonstrated ability to manage and motivate a team and KPIs for productivity
• Demonstrated ability to problem solve automation and enhancements to improve RCM cycle time
  
  

Additional Requirements

• Employees in this role are considered essential workers as part of the critical infrastructure.
• No prior criminal history.
• Ability to use technology.
• Proficient Microsoft suite knowledge, specifically Excel.
• Central Reach
  
  

Disclaimer

Please note this job description is not designed to cover or contain an exhaustive list of all expectations, duties or responsibilities that are required of the employee for this job; employees may be required to perform additional functions. The company reserves the right to revise the job description at any time. The employee must be able to perform the essential functions of the position satisfactorily. If requested, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of their job, absent an undue hardship.