Revenue Cycle Management Director

SUMMARY OF RESPONSIBILITIES:

We are seeking a Director of Revenue Cycle Operations to oversee and optimize the full scope of our revenue cycle processes. This individual will be accountable for ensuring the accurate and timely billing of services, while also driving efforts to maximize collections across all accounts.

In this role, you will collaborate closely with both finance and operational teams, offering insights and strategic guidance to support organizational decision-making. You’ll be responsible for providing strong leadership and direction across the entire revenue cycle function.

The role will play a key factor in the daily operations related to revenue cycle activities, offering data-driven analysis, documenting workflows, and training staff as needed to ensure efficiency and compliance.

MINIMUM QUALIFICATIONS:

• Bachelor’s Degree in Healthcare Management, Business Administration or commensurate experience required.
• Minimum of five years of RCM experience in a relevant field with a proven track record of results.
• Minimum of 3 years of experience in a leadership role, accountable for team performance.
• Demonstrated leadership skills that are empowering, constructive and supportive.
• Knowledge of professional fee billing, reimbursement, and third-party payer regulations.
• Working knowledge of regulatory requirements pertaining to health care operations.
• Strong work ethic and motivated by growth, hitting goals and exceeding targets.
  
  

 ESSENTIAL DUTIES/RESPONSIBILITIES: 

• Manages RCM operations including all aspects of coding, charge-entry, claims submission, collections and payment posting.
• Lead and motivate revenue cycle team to optimize the collection of revenue, improve revenue management processes and implement new approaches to increase efficiency, productivity and revenue while improving the client’s experience.
• Establish strong relationships and communicate effectively with all constituents, including patients, clients, third party payers, vendor partners, RCM colleagues and other leadership staff.
• Partner with finance and operations teams to evaluate collection capabilities and adherence to payer contracts.
• Actively partner with finance, data and operations teams to develop and implement monthly reporting and analyze actionable claims data.
• Continually improve processes, implement industry best practices, and improve outcomes by implementing innovation not currently in use.
• Lead Denial Management processes to eliminate denial root causes and reduce the denial impact on the organization.
• Manage process to timely bill and adjudicate claims that supports maintaining a benchmark goal level.
• Facilitate the development of departmental mission, goals, policies, procedures and work standards of the RCM Team.  Also review the RCM departments’ performance and ensure compliance.
• Maintain a working knowledge of applicable Federal, State and local laws/regulations; as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.
• Maintains a professional working relationship with all persons served including a demonstrated commitment to person centered care and recovery-oriented approaches to care.  
• Completes all other duties and special projects as assigned.
  
  

CORE COMPETENCIES 

Demonstrates Dependability: 

• Arrives to work on time according to agency policies
• Uses leave time according to agency policies
• Completes documentation/paperwork and projects within deadlines

Demonstrates Flexibility & Initiative: 

• Assumes additional responsibilities and a willingness to assist colleagues
• Works different shifts when necessary
• Recommends program changes and improvements

Demonstrates Teamwork: 

• Maintains an overall work attitude of cooperation and professionalism in all interactions with agency staff and community professionals
• Attends and participates in required staff meetings and agency-wide committees
• Receptive to direction and feedback from supervisor

Demonstrates Professionalism:

• Conducts self in professional manner with colleagues, peers, and persons served
• Recognizes the rights of clients; and will protect privacy of persons served at all times by following agency, State, and Federal mandated privacy procedures and regulations  
• Adheres to agency Code of Ethics at all times
• Complies with all agency policies and procedures, laws and regulations under which the agency operates