Vice President - Intake, Verification, Authorization, & Revenue Cycle Management

Description

Performance Home Medical has been a leader in providing quality products and services since 1995.

At Performance Home Medical, our patients come first. Using the latest technology and best clinical support, we help our patients take control of their conditions and live longer and healthier lives.

The Vice President of Intake, Verification, Authorization & Revenue Cycle Management (RCM) oversees the end-to-end patient intake process, insurance verification, prior authorization, and the broader revenue cycle. This includes ensuring that patient access and financial processes—from the first point of contact to final account resolution—are efficient, compliant, and optimized for maximum reimbursement. The ideal candidate has extensive expertise in healthcare operations, payer relations, and regulatory compliance, along with a track record of guiding cross-functional teams in a fast-paced environment.

We’ve got a fun, positive, performance-oriented team. We offer a competitive salary and a great career path.

Strategic Leadership

• Develop and implement a strategic vision for intake, verification, authorization, and revenue cycle activities aligned with organizational goals.
• Collaborate with executive leadership to set short- and long-term objectives focused on revenue growth, patient satisfaction, and operational excellence.

Patient Intake & Registration

• Oversee patient intake procedures to ensure accurate collection of demographic and insurance information.
• Implement best practices to streamline registration, reduce wait times, and improve the overall patient experience.

Insurance Verification & Authorization

• Direct teams responsible for insurance verification and prior authorization to confirm coverage eligibility and secure approvals.
• Establish and maintain payer relationships to address eligibility, coverage, and pre-certification issues promptly.

Revenue Cycle Operations

• Lead all revenue cycle functions, including billing, collections, payment posting, and denial management.

• Ensure timely claim submission, proactive follow-up on outstanding balances, and swift resolution of payer disputes.

Process Improvement & Technology

• Identify workflow inefficiencies, propose action plans, and champion initiatives to reduce errors and accelerate turnaround times.
• Evaluate and adopt technology solutions (e.g., EHRs, billing software, automation tools) that enhance data accuracy and operational efficiency.

Financial Performance & Analysis 

• Track KPIs such as days in accounts receivable, authorization turnaround times, denial rates, and overall collection efficiency.
• Provide regular performance reports to executive leaders, offering strategic recommendations for improvement.

Compliance and Regulatory

• Ensure adherence to HIPAA, CMS guidelines, and other federal, state, and local healthcare regulations.
• Stay current on payer requirements, coding standards, and reimbursement models to maintain compliance.

Team Leadership & Development

• Recruit, train, and mentor managers and staff across intake, verification, authorization, billing, and collections.
• Promoting a culture of accountability, innovation, and professional growth.

Cross-Functional Collaboration

• Coordinate with clinical leadership to confirm authorization protocols align with care pathways.
• Partner with finance, IT, and other departments to integrate RCM processes with wider organizational objectives.

Vendor & Payer Relations

• Negotiate contracts with third-party vendors and payers, securing favorable terms and timely issue resolution.

• Represent the organization at external forums to stay updated on industry trends and regulatory developments.
• Other duties as assigned by my manager.

Qualifications

• Bachelor’s degree (B.A.) in finance, Business Administration, Healthcare Administration, or related field; master’s degree (MBA, MHA, MPH) strongly preferred
• Certification in healthcare financial management or revenue cycle (e.g., HFMA, AAHAM) are a plus. 10 years of leadership experience in healthcare revenue cycle management, focusing on intake, verification, and authorization.
• Must hold or have previously held a position as a Vice President of Revenue Cycle.

• Proven success in improving metrics such as A/R days, clean claim rates, and denial rates. History of overseeing multi-state or multi-functional teams in mid-to large -scale healthcare settings.

• Proficiency with RCM software, EHR systems, and data analytics tools.
• Strong knowledge of payer guidelines, coding (ICD-10, CPT, HCPCS), and reimbursement models (fee-for-service, capitation, value-based care).
• Excellent communication and collaboration skills for both internal and external stakeholders.
• Demonstrated strategic thinking, problem-solving, and a results-driven approach.
• Ability to develop and empower high-performing teams in a dynamic environment.