What are the responsibilities and job description for the Director of Revenue Cycle position at Little Leaves?

Company Overview

This position is responsible for the success of the revenue cycle management function, closely managing all billing, prior authorizations, and credentialing team members. The position will constantly analyze and optimize processes, perform root cause analysis of claim denials, and maximize both client satisfaction and revenue. They will also develop metrics and reporting that relate to authorization management, credentialing, contracting and the revenue cycle at Little Leaves, while ensuring compliance with all applicable regulations.

Responsibilities

Essential Job Functions :

Develop objectives and key results related to RCM functions
Drive optimization and standardization of processes to meet or exceed objectives
Utilize revenue cycle analytics platforms, including dashboards and reporting tools, to improve short-term outcomes and develop long-term goals
Partner with organizational leadership to ensure appropriate staffing levels and optimal balance of workload
Partner with cross-functional leadership and key stakeholders in analysis of claim denials, underpayments, compliance risks, client satisfaction, client financial counseling, and change management procedures
Partner with Accounting to reconcile each month the practice management system and general ledger
Ensure compliance with all applicable billing regulations, payer guidelines, third-party regulations, and Little Leaves standards
Actively seek out and implement process improvement opportunities
Develop and implement strategic plan to address accounts receivable aging, including utilizing industry benchmarks and other available resources to set and achieve goals
Drive innovation in economic and clinical performance as it relates to revenue cycle
Develop and implement internal audit processes and performance criteria for all revenue cycle roles to support reaching goals and metrics, using results to identify training opportunities
Provide revenue cycle leadership representation on committees and special projects
Develop and maintain revenue cycle written standards, standard operating procedures (SOPs), and other policies and practices to achieve high performance objectives (e.g. DSO, provision rate, denial rate, etc.)
Facilitate a partnership between revenue cycle and other internal management teams that optimizes coverage and reimbursement for services rendered
Consistently demonstrate a high level of integrity, responsibility, accountability, teamwork and ethics
Follow all Company policies and procedures and serve as a model for others to follow such policies and procedures
Performs other duties, as requested

Positions Supervised (Direct Reports) :

Billing & AR Team

Authorization Team

Skills, Abilities, and Other Requirements :

Experience in establishing internal controls across functions and quality controls within functions

Experienced in health insurance contracts, authorizations and coding, i.e. CPT, HCPCS, ICD-10

Excellent communication and presentation experience

Experiences in accounting transactions, general ledger maintenance and reconciliations

Understanding of HCFA 1500 insurance claims processing via electronic data interchange (EDI)

Experience setting up and maintaining Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT)

Understanding of insurance claim rejections and denials and appropriate resolutions

Understanding of best practices in billing and collections

Experience setup and maintenance of practice management systems

Ability to identify issues in systems or processes and work with the team to resolve effectively

Understanding of revenue cycle reporting and metrics

Exercise confidentiality and discretion pertaining to the work environment

Sensitive to working with an ethnically, linguistically, culturally, and economically diverse population

Demonstrate high commitment to excellent customer service

Demonstrate flexibility and ability to reprioritize

Commitment to functioning as a team player

Maintain required trainings

Must clear DOJ / FBI background check and exclusion screening process, prior to and during employment

Qualifications

Minimum Education or Training Equivalent to :

Master's degree from an accredited college or university in one of the following disciplines : accounting, healthcare management or business management, preferred

Bachelor's degree from an accredited college or university in one of the following disciplines : accounting, healthcare management or business management, required

Minimum Additional Related Experience :

Ten or more years of experience in revenue cycle management or accounting / finance in the healthcare industry, preferred

Posted Salary Range

USD $100,000.00 - USD $125,000.00 / Yr.

Salary : $100,000 - $125,000

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Director of Revenue Cycle

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