Associate Director of RCM, Patient Access and Accounts (Collections)

About the Company

CardioOne partners with independent cardiologists to provide innovative solutions that improve patient outcomes and reduce costs. Our platform helps our physician partners thrive in today’s fee-for-service environment and prepare for success in value-based care. In February 2024, we partnered with WindRose Health Investors as well as top physician services and payor executives to grow our team and invest in our next phase of growth.

CardioOne offers a magnificent work environment, good working conditions, and competitive pay. We offer medical, dental, vision, and a 401k plan with a match to benefit eligible employees. We offer PTO (Personal Time Off) and sick time to full-time employees. We take pride in creating a culture of employee engagement that translates into an exemplary patient experience. Join us in our mission to positively impact US cardiology.

About the Job

CardioOne is hiring an Associate Director of Revenue Cycle Management - Patient Access and Accounts (Collections) to join their ever-growing team! You will be an essential member responsible for supporting and leading revenue cycle operations at our cardiology practices to achieve maximum efficiency and performance. You will aim to lead the reduction of inefficiencies and help the organization avoid losing access to reimbursement while improving the overall patient experience. You will report directly to the VP of Revenue Cycle Management Operations and work remotely.

What you’ll do:

• RCM Patient Access and Account Resolution – Oversee and direct the strategic activities of revenue management for front end teams and processes, that support organizational compliance, fiscal sustainability, and member accountability. Collaborate with practice partners, practice managers, and operations to routinely review KPI reports that recognize trends, perform root-cause analysis, and develop/deploy workflow improvement opportunities that adhere with policy and procedures. execution of standardized policies and procedures to produce predictable high-quality financial outcomes for all practices. This includes overseeing the productivity and quality/accuracy of RCM functions (i.e. appropriate scheduling, authorization, scrubs/denials, insurance package maintenance, clinical inbox, patient portal inquires, patient call resolution), providing training and education for continued adherence to workflows and scalability.
• Compliance and Internal Controls Support – Support access reviews and maintenance of payer portals for accurate billing/collections and patient follow-up actions. Ensure compliance with government and commercial payer contracts, payer relations and Athena system edits/custom rules, ACO agreements, MIPS/MACRA, coding standards, and CPT Category II quality reporting. Enact routine reviews and audits of processes, serving as the initial point of contact for escalation for RCM patient related issues, and aid in developing action plans to address negative trends or unfavorable audit outcomes.
• RCM Key Performance Indicators and Optimization - Serve as an expert resource in monitoring and maintaining/exceeding RCM KPI’s in Access Management targets (scrub reductions, missing slips management), Cost to Collect, Clinical Inbox Management, Avoidable Denials, Clean Claim Submission Rate, TOS Collections, and Net Collections Rate. Continue assisting RCM and practices in improving the patient experience, efficient service delivery, and financial performance.
  
  

What you’ll need:

• Bachelor's degree or equivalent experience.
• 6-8 years of equivalent and relevant experience in RCM / process management.
• Excellent supervisory, managerial skills of personnel to include vendor management.
• Athena Health EMR knowledge strongly preferred
• Knowledge of medical billing, front office, physician practice management and healthcare business processes and workflow.
• Understanding of medical billing/coding with an understanding of various insurance carriers, including Medicare, private HMOs and PPOs.
• Excellent written, verbal and interpersonal communication skills for a variety of audiences.
• Strong organizational skills with ability to handle multiple tasks simultaneously.
• Knowledge of financial reporting required.
• Demonstrated analytical thinking and problem-solving ability. Can systematically and logically work to identify causation and resolve problems.
  
  

Work Location:

Remote: Texas or Colorado (preferred), Florida, New Hampshire, New Jersey, New York, Pennsylvania.

Additional Information

Full-time base salary of $80,000-$110,000 plus medical, dental, vision benefits along with a matching 401K.