Dir Revenue Cycle

Job Summary

The Director, Revenue Cycle provides overall leadership, management and direction of the revenue cycle function. Responsibilities include but are not limited to DAR/Pulse documentation, Alert/APC edits, billing guidelines, uniform CDM, support system requests, external vendor systems, create and define strategic objectives and implementing process redesign, policies and measurement tools.

Essential Functions

• Defines and establishes strategic direction and priorities for the revenue cycle operations.
• Directs the management and operations of Revenue Cycle/Collections services to provide high quality cost-effective customer service.
• Works with leadership to implement best practice workflows and ensures adherence to policies and procedures as related to revenue cycle operations.
• Oversees all revenue cycle processes and ensures key metrics are met by analyzing data and optimizing performance.
• Responsible for ensuring all escalations related to daily operations revenue cycle are handled appropriately; notifying leadership as appropriate.
• Effectively leads, coaches, and counsels supervisors, managers, and other revenue cycle team members as necessary.
• Reviews action plans and educates supervisors, managers, and clinic operations teams (staff, providers, leadership) on proper follow up techniques.
• Reviews daily, weekly, and monthly clinic operations indicators and takes appropriate steps with leadership to address and improve.
• Audits transactions posted to patient accounts to ensure accuracy; educates where appropriate.
• Audits staff investigation and resolution of billing concerns; educates where appropriate.
• Audits and reconciles cash with Bank and General Ledger to insure proper controls and complete accountability of funds received.
• Participates in integration efforts for new practice management systems/vendors including on site training and installation of policy and procedures for revenue cycle or other related areas of responsibility (i.e. Ingenious Med Utilization).
• Responsible for routine on site review of daily practice operations; ability to assess and complete gap analysis of all work streams that intersect with revenue cycle working with corporate resources, clinic operations including leadership; and other area leaders to ensure all gaps are closed.
• Responsible to review monthly KPI’s and communicate problematic trends for intervention and resolution with corporate including leadership as appropriate.
• Responsible for working knowledge of payer fee-for-service contracts and value-based care contracts.
• Possess ability to work in a matrix environment where multiple or competing customer demands are likely.
• Performs other duties as assigned.
• Complies with all policies and standards.

Qualifications

• Bachelor's Degree in Business Management, Healthcare Administration, Public Health, or a closely related field required
• Master's Degree in Business Management, Healthcare Administration, Public Health, or a closely related field preferred
• 7-9 years progressive management experience in Healthcare Revenue Cycle Operations required

Knowledge, Skills and Abilities

• Google Suite including Gmail, GDrive, GSheets, GCalendar, etc.
• Microsoft Office Suite including Word, Excel, Power Point, and Visio
• Kronos, Athena, and the ability to learn multiple new systems being used in the organization to perform daily operational activities

Licenses and Certifications

• CPB Certified Biller through AAPC preferred
• CMIS through PMI preferred
• CMRS through ABA preferred