Director of Revenue Cycle Management

JOB SUMMARY: Responsible for all aspects of the Revenue Cycle Management functions for a large multi-site healthcare provider with exceptional growth plans.

Please join our team at Eventus WholeHealth as a Revenue Cycle Manager at an innovative state-of-the-art practice where you can earn between $125,000-$150,000 per year in a private practice setting.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Responsible for the management of teammates and responsible for the areas of patient intake, insurance collections, patient collections, credit balance resolution, payment posting, claims submission, denial management, and coding and documentation, along with the management of revenue cycle management vendors who are providing billing, cash application and A/R follow-up.
• Develops and manages operating metrics such as backlog reporting, collections status, A/R > 90, credit balance ratio, employee productivity, managed care reporting, DSO, etc.
• Motivates the department, providers and vendors to demonstrate continuous improvement in all areas.
• Implements an effective denial management program that demonstrates success in reducing the company’s overall denial rate while improving operating efficiency and timeliness of collections.
• Works cohesively with the other departments such as operations, finance, accounting, managed care and legal to develop effective policies and procedures that drive operating performance while maintaining compliance with all federal, state and regulatory requirements.
• In conjunction with the CFO and CEO the individual will develop and manage key performance indicators for the department.
• Individual will have the ability to work with the Finance department in determining appropriate revenue recognition on a monthly basis for the company and achieving the required revenue and bad debt reserve targets.
• Analysis of accounts receivable data (e.g. days outstanding in AR, percent of accounts over 60/90/120 days old, bad debt percentages, DSO, etc.), extraction into meaningful presentations, and communication of results as well as identifying problem sources and developing an action plan for continuous improvement.
• Providing relevant and timely feedback to the operational leaders regarding coding and documentation.
• Works closely with Operations, IT, and Finance to train staff as well as define and implement procedures on front-end processes such as data collection, patient collections, and insurance/benefits verification.
• In conjunction with Finance and Operations, the evaluation and implementation of technological tools to improve efficiency and productivity in the management of fee schedules, payer contracts, and accounts receivable.
• Development and reporting on benchmarks and key indicators of revenue cycle functions to be reported on a daily, weekly, and monthly basis.
• Analysis of data requirements of Finance staff and Senior Management to oversee the creation and production of a range of reports to address those needs, including denial reports, error reports, accounts receivable reports, revenue forecasts, and ad hoc reports.
• Ongoing interaction with Payer Contracting leadership to address problems that may arise and to ensure accurate and timely reimbursement.
• Assessing and managing current technology and application software for revenue cycle operations as well as serving as the strategic liaison with each client/vendor.
• Performs other duties and responsibilities as required or assigned.
• Some travel maybe required.

EDUCATION and/or EXPERIENCE:

Bachelors degree in finance, accounting, healthcare or business administration; A thorough understanding of revenue cycle management is required, along with a thorough understanding of transactions involving federal, state or local government insurance programs (e.g., Medicare/Medicaid). The ideal candidate will have a minimum of ten years of success in leading billing/revenue cycle operations, business development and client/vendor relationships, preferably in a healthcare professional services billing organization with multi–state and multi-site distributed environment experience.

OTHER SKILLS and ABILITIES:

Ability to use copier, fax machine, printer, calculator and multi-line telephone. Must be proficient with computers with an understanding of medical billing software. Advanced knowledge of medical terminology as well as knowledge of government and private insurer rules and regulations. Advanced knowledge of CPT, ICD-10 and HCPCS coding, as well as in-depth knowledge of medical billing requirements. Working knowledge of Microsoft Outlook, Word, Powerpoint and Excel. Ability to utilize the internet, specifically Medicare and Medicaid websites. Must be able to maintain confidentiality in regard to HIPAA rules and regulations, as well as private company matters.

SUCCESSFUL COMPETENCY FACTORS:

Use of the following skills: leadership, problem solving, analytical ability, decision making, oral and written communication skills. Interpersonal skills necessary to successfully work with subordinates, peers, company executives, insurance carriers, government and private agencies.

WORKING RELATIONSHIPS:

Daily contact with carriers by email and by telephone. Daily contact with team members and other employees in the corporate office.