Revenue Cycle Management Director

Position Title: Director of Revenue Cycle Management

Job Summary: The Director of Revenue Cycle Management is responsible for overseeing and managing all aspects of the revenue cycle process of our psychology practice specializing in skilled nursing and long-term care facilities. This includes but is not limited to insurance Super

Essential Functions:

• Lead and oversee all billing, coding, claims submission, payment posting, and collections processes.
• Implement strategies to improve clean claims rate, reduce denials, and maximize reimbursements from Medica, Medicaid, and commercial plans.
• Monitor key revenue cycle KPIs, including days in A/R, denial rates, collection rates, and bad debt writ-offs, and take corrective action as needed.
• Lead the claims management process, ensuring timely submission and minimizing rejections.
• Develop and implement collections strategies to reduce accounts receivable days and improve cash flow.
• Collaborate with clinicians and administrative staff to improve charge capture, documentation accuracy, and billing workflows.
• Serve as the liaison with insurance companies, negotiating contracts and resolving reimbursement issues.
• Stay up to date on changes in Medicare, Medicaid, and commercial payer policies to ensure the practice is fully compliant and maximize reimbursements.
• Implement and optimize RCM technology solutions (EHR, billing, software, clearinghouses) to improve efficiency.
• Lead automation initiative to streamline workflows, such as electronic claims submission and automated eligibility verification.
• Develop and enforce standard operating procedures for revenue cycle functions.
• Manage relationships with third-party vendors, such as billing companies and collection agencies, to ensure quality and cost-effective services.
• Ensure full compliance with HIPAA, CMS regulations, and state/federal healthcare billing requirements.
• Conduct internal audits to identify and mitigate compliance risks related to coding, billing, and documentation.
• Provide ongoing training and education to staff on revenue cycle processes, regulations, and best practices.
• Participate in team meetings and contribute to quality improvement initiatives.
• Adhere to practice policies, procedures, and protocols.
• Lead by example in embodying the organization's mission, vision, and values.
• Travel Requirements: up to 10%

Supervisory Responsibilities:

• Provide leadership and direction to the revenue cycle team, including hiring, training, and performance management.
• Foster a collaborative work environment, ensuring strong communication between the revenue cycle team, clinicians, and leadership
• Establish clear performance metrics and accountability for the RCM team.

Qualities & Skills:

• Excellent verbal and written communication.
• Ability to multitask and work in a fast-paced environment.
• Compassionate and empathetic attitude towards patients.
• Demonstrate time management skills by efficiently prioritizing tasks, and patients simultaneously.
• Proven ability to work collaboratively within a team environment.
• Highly adaptable and willing to adjust to changing priorities and conditions.
• Strong Knowledge of Microsoft Office Suite.
• Proficiency in using electronic health records (EHR) systems.
• Strong leadership and management skills, with the ability to motivate a team.

Education & Experience:

• High School diploma or equivalent required.
• Bachelor's degree in healthcare administration, finance, or related field. Master's degree preferred.
• 5 years of experience in revenue cycle management, preferably in a healthcare setting, with direct experience with Medicare/Medicaid billing.
• In-depth knowledge of healthcare billing and coding practices, as well as relevant regulations.
• Experience with revenue cycle management software and other technology solutions.

Benefits:

• Competitive salary
• Health/Vision/Dental Insurance Benefits
• 401K Plan
• Opportunities for professional development and advancement
• Collaborative and supportive work environment
• Work-life balance initiatives

Salary: $70,000-$85,000 Annually