Revenue Cycle Director

Native Preference in hiring is given to qualified enrolled members of Paskenta Band of Nomlaki Indians and Native Americans in accordance with the Band’s Preference Policy (Chapter 1-715 of the Paskenta Band of Nomlaki Indians Tribal Policies). Applicants claiming Indian Preference must submit verification of Indian certified by tribe of affiliation or other acceptable documentation of Indian heritage.

POSITION SUMMARY

The Director of Revenue Cycle is a key member of the executive team providing strategic planning and operational oversight of revenue cycle management. This includes driving revenue growth, establishing necessary policies and processes, and providing leadership for revenue-generation within the organization. The Director of Revenue Cycle plays a crucial role in developing, implementing, and optimizing strategies to achieve the organization's financial and patient care objectives.  This executive team member serves as a liaison for the organization in establishing and developing relationships with specialists and subcontractors.

DUTIES & RESPONSIBILITIES

• Oversees and monitors the revenue cycle for Rolling Hills Clinic.
• Serves as an executive lead in organizational strategic planning.
• Supervises and supports the revenue cycle team and/or subcontractors, providing necessary guidance, training, and development to ensure high performance.  
• Ensures accurate and efficient processing of charge capture, coding, billing, and collections by working with staff and subcontractors. 
• Serves as a liaison to subcontractors carrying out the revenue cycle and health information management.
• Lead for transition of RHC to a TFQHC and billing outside of four walls.
• Ensures timely and accurate submission of claims to payers, resolving any issues that arise to minimize delays in payment.
• Create and implement strategies to enhance revenue cycle performance, improve financial outcomes, and reduce costs.
• Analyzes revenue cycle metrics to identify trends, areas for improvement, and cost-saving opportunities, using this data to inform decision-making.
• Effectively liaisons with specialists and vendors, bringing opportunities for growth and services expansion to leadership for review.
• Works closely with other departments to ensure the revenue cycle processes are well integrated with overall business operations.
• Stays informed about the latest coding and billing regulations and ensure compliance with all relevant laws, regulations, and internal policies.
• Maintain relationships with external vendors and payers to ensure efficient and effective revenue cycle operations.
• Maintains a solutions-based approach and promotes positive leadership.
• Maintains the clinic’s sliding fee scale and informs leadership of any potential impacts with changes thereof.
• Performs other duties as assigned.

MINIMUM QUALIFICATIONS

• Bachelor's degree in business administration, health care administration, or related field and a minimum of ten years of industry related experience in health care.  MBA or equivalent master’s degree preferred.
• Extensive Healthcare Experience required.  Minimum 7 years of revenue cycle experience. Executive Experience preferred.
• Experience working with Tribal populations is helpful and knowledge of health disparities highly desired.
• Experience working within a TFQHC and/or FQHC.
• Knowledge of ICD-10 Codes, Revenue Codes, and Place of Service Codes.
• Superior Knowledge of CMS, Payor credentialing and revenue cycle functions.
• Knowledge of EHR system(s).
• Current CPR certification.

SKILLS:

• Clear, concise, and persuasive writing, communication, and presentation skills.
• Strong analytical and problem-solving skills.
• Strong interpersonal skills.
• Strong orientation to deadlines and details.

ABILITIES:

• Ability to work effectively and congenially with diverse employees at all levels.
• Ability to understand and interpret insurance laws and regulations.
• Ability to exercise good judgment under pressure.
• Ability to manage a diverse and demanding workload.
• Ability to competently use Microsoft Office, including Word, PowerPoint, Excel, and appropriate practice management software.

LANGUAGE SKILLS

1. Bilingual skills are preferred, but not necessary for this position. 

BACKGROUND CHECK REQUIREMENTS

Pre-employment Drug Testing and a Department of Justice Fingerprinting clearance through Federal, State and Child Abuse Index is a contingency for an offer of employment. Criminal clearances are obtained to protect the welfare and safety of clients receiving services at Rolling Hills Clinic.

VACCINATION REQUIREMENTS

A pre-employment Physical exam is required upon hire. You will be required to provide vaccination records to show proof of immunity for Covid-19, TB or PPD, Measles, Mumps, Rubella, Varicella, TDAP & Hep B. If the records are more than 10 years old, titers are required to confirm immunity.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and hear.  The employee frequently is required to stand, walk, sit, use hands to finger, handle, or feel; and reach with hands and arms.  The employee is occasionally required to stoop.  The employee must occasionally lift and/or move up to 25 pounds.  Position may require exertion up to 20 pounds of force occasionally and/or up to 10 pounds of force frequently or constantly lift, carry, push, pull or otherwise move objects. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

WORK ENVIRONMENT

Work is performed in a health clinic setting.  The noise level in the work environment is usually low to moderate. Will work with blood-borne pathogens and will require OSHA training.  This job routinely uses standard office equipment such as computers, telephones, photocopiers, and fax machines. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Employment with Rolling Hills Clinic is voluntarily entered into.  All RHC personnel are employed on an at-will basis.  At-will employment may be terminated with or without cause, and with or without notice at any time by the employee or by RHC.  No manager, supervisor, or employee of the organization has any authority to enter into an agreement for employment for any specified period of time or to make an agreement for employment other than at-will terms. The job description does not constitute an employment agreement between Rolling Hills Clinic and employees and is subject to change by the Paskenta Band of Nomlaki Indians.