Director Revenue Cycle Management Facility

On site Phoenix position.

ESSENTIAL FUNCTIONS

• Develop strategic plans and programs for the Revenue Cycle team and ensure objectives of the team are properly defined, implemented, and clearly monitored.
• Responsible for directing the management of the revenue cycle by establishing and maintaining standards, systems and processes that are effective, addresses identified needs and ensures achievement of established company goals.
• Monitor timeliness and effectiveness of department activities, ensuring that posted charges, accounts receivable, and denial percentages are within target.
• Responsible for denial management including trending, root cause analysis and action planning to educate on areas to focus to reduce overall denial rates.
• Develops, implements, and administers department policies and procedures in a consistent and timely manner to improve the quality and quantity of work processed. Makes recommendations for improvement and ensures policies are communicated and administered consistently.
• Perform strategic planning, effectively presents information, and responds to questions from physicians, management, payers and patients.
• Develops and manages processes to audit and monitor charge capture, denials, and adjustment management.
• Provides ongoing guidance and feedback to clinical leaders to optimize revenues and eliminate barriers that reduce collectibles.
• Identifies and resolves billing issues in a timely manner to ensure both quality patient customer service and maximization of cash flow.
• Collaborates with clinical and operational departments to ensure registration meets the needs of all parties.
• Supervises, trains, orients and evaluates performance over assigned personnel. Monitors daily activity of the department and makes necessary adjustments in work assignments.
• Maintains in depth knowledge of Medicare, Medicaid, commercial insurance, and managed care plans to ensure compliance with payer regulations, plan documents, as well as billing compliance with Federal and State law.
• Maintains confidentiality regarding patients’ accounts status.
• Supervise and appraise performance of direct reports on an ongoing basis, provide training and resources to ensure direct reports continue to develop skills and knowledge of job-related functions, and ensure same is done for staff reporting to the direct reports.
• Ensures compliance with federal and state laws specifically pertaining to the revenue cycle.
• Ensure the Revenue Cycle processes are controlled through Performance Metrics and Standards
• Conduct meetings with the teams, to help ensure the implementation of Revenue Cycle plans, programs, and projects strictly adhere to prescribed deadlines and schedules.
• Other job duties as assigned

EDUCATION

• Bachelor’s Degree or an equivalent combination of education and experience required.

EXPERIENCE

• Minimum five years of experience in a supervisory, manager or leadership role in Hospital revenue cycle operations. Prefer experience working with multiple physician specialties. 

REQUIREMENTS

• CPC coding certification - Must have
• Hospital Revenue Cycle experience - Must have

KNOWLEDGE

• Knowledge of business management and basic accounting principles to direct the revenue cycle.
• Knowledge of computer accounting programs, spreadsheets, and applications.
• Comprehensive knowledge of claims management, HIPAA standards, CMS requirements, managed care, CPT, ICD-9, 10 and HCPCS coding.
• Strong background in financial management with knowledge of complex reimbursement structures and governmental regulations to the billing processes.

SKILLS

• Excellent verbal, written and attentive listening communication skills.
• Skill in developing, implementing, and administering budgets.
• Skill in supervising staff and serving as a resource to management.
• Strong analytical, problem solving and critical thinking skills to interpret complex revenue cycle metrics/results/plans and strategies into operational plans.
• Skills in focused project management, must be a well-organized and self-directed individual.
• Proven skill in basic revenue cycle operations and building alignment with clinic/ASC/hospital partners.