REVENUE CYCLE & COMPLIANCE DIRECTOR

VACANCY ANN #:   STOI-25-024
TITLE:                           REVENUE CYCLE & COMPLIANCE DIRECTOR 
SUPERVISOR:           CEO, DAVID C. WYNECOOP HEALTH CENTER
DEPARTMENT:         DAVID C. WYNECOOP HEALTH CENTER
LOCATION:                WELLPINIT, WA
STATUS:                     CONTRACT, EXEMPT
RATE OF PAY:           DOE/DOQ 
OPENING DATE:       MARCH 10, 2025
CLOSING DATE:       MARCH 14, 2025

SUMMARY:

Revenue Cycle and Compliance Director is the senior-level position responsible for overseeing all aspects of David C. Wynecoop Memorial Health Center revenue cycle management, including patient registration, insurance verification, coding, claims submission, payment posting, denial management, and collections, with the primary goal of maximizing revenue by ensuring accurate and timely billing practices while adhering to all regulatory compliance. The Director of Revenue Cycle serves as the programmatic and operational leader for Revenue Cycle and is responsible to the Chief Executive Officer and works closely with the CFO and employees and supports clinic-wide projects and initiatives that relate to Spokane Tribes priorities, health care legislation and compliance, systems redesign, improved revenue, and/or reduced cost. Serves as Subject matter expert on Healthcare Compliance for the Health Center.

Responsible to lead teams, analyze data, identify areas for improvement, and implement strategic initiatives to optimize the revenue cycle process across the organization. This includes establishing, meeting and continuously monitoring the goals and objectives while maintaining alignment with the strategic goals and objectives for DCWMHC.

Serves as leader or subject matter expert in Revenue Cycle data, which includes the initiation and assistance in identification and implementation of operating improvements and efficiencies by identifying important trends and variances.

The Director works closely with a variety of stakeholders, coordinating the activities of the Revenue Cycle and Compliance across the Health Center.

The RCM/Compliance Director ensures that DCWMHC adheres to all applicable laws, regulations, and policies. They are responsible for developing, implementing, and monitoring compliance programs that help the organization stay within legal and ethical boundaries.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Manage DCWMHC Revenue Cycle team and oversee all front-end and back-end revenue cycle operations through multiple platforms.
• Actively seeks opportunities to improve financial outcomes, engaging staff in the process.
• Oversee billing processes, ensuring accurate coding, submission, and follow-up on claims to maximize reimbursement.
• Analyze key performance indicators (KPIs) related to the revenue cycle, such as days in AR, clean claim rate, denial rate, and collection efficiency and cash collections to identify areas for improvement.
• Oversee insurance billing and patient billing, ensuring that all clients are billed accurately and in a timely manner following their sessions.
• Ensure adherence to all relevant healthcare regulations, including HIPAA, CMS guidelines, and state regulations, by implementing appropriate controls and monitoring compliance. Establish or ensure other policies and procedures which demonstrate compliance with required regulations.
• Able to assist in Cost Report preparation and submission.
• Establishes annual financial goals and actively uses benchmarking to high performing systems in similar areas of expertise to set annual targets.
• Monitors and analyzes financial data and utilizes in decisions regarding FTE’s, staffing and operational budget.
• Identify and implement cost-saving initiatives within the revenue cycle operations. 
• Prepare regular reports on revenue cycle performance, including key metrics and trends, for Leadership and Health Board. 
• Monitors and analyzes financial data and utilizes in decisions regarding FTE’s, staffing and operational budget.
• Establishes an annual operating and capital budget, demonstrating fiscal responsibility through meeting budget targets.
• Creates business plan(s), justifying variances and analyzing cost benefit of programs.
• Directs and provides guidance to managers to effectively allocate resources based on patient volume, space availability, budget constraints, and program priorities, goals and objectives.
• Articulates to staff the budget and the context within the organizational financials.
• Maintain records related to operations and services that are complete, accurate, available, and in compliance with all legal, regulatory, and policy requirements.
• Remains current of new trends and best practices and incorporates into Revenue Cycle practices and programs.

KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:

• Strong analytical skills to identify trends and interpret data.
• Proven leadership and team management abilities
• Proficiency in revenue cycle management software and systems
• Must adhere to the confidentiality Health Insurance Portability and Accountability Act (HIPAA) policies.
• Must provide documentation of immunity to measles, and rubella, or become vaccinated with the recommended vaccines and hepatitis B vaccine Must test for Tuberculosis (TB) at time of hire and per the National Centers for Disease Control (CDC) guidelines as required. Must have an annual health exam and a flu immunization and Coronavirus Disease (COVID-19) vaccination or exemption as required.
• Must successfully pass a Pre-employment drug screen test and submit to a criminal background check.

MINIMUM REQUIREMENTS:

• Bachelor's degree in healthcare administration, business, or related field. Master’s preferred
• Relevant healthcare certifications, especially in Compliance.
• Deep understanding of healthcare revenue cycle management processes, including coding, billing, and collections as demonstrated by at least 10 years in Revenue Cycle Management
• Expertise in relevant CMS healthcare regulations and compliance requirements
• Must possess a valid driver’s license, good driving record, and be insurable by the Tribe’s insurance carrier

*Indian Preference Applies – Indian Preference grants preference to any enrolled member of a federally recognized tribe.

*Safety Sensitive Background – Requires a higher standard of performance and behavior.

MUST APPLY ON-LINE:

Confirmation receipt of on-line application submission and interview status will be sent to all applicants e-mail address used when applying. Applicants are responsible to regularly monitor their e-mail for interview notifications.

Contact: Sabrina McCoy, HR Specialist, or Kammi Rosenbaum, HR Administrative Assistant

(509) 458-6583 or (509) 458-6527

E-mail: hrfrontdesk@spokanetribe.com

All Applications Must Be Received in the HR Department No

Later Than 4:30pm on the Closing Date

The Spokane Tribe of Indians Reserves The Right To Hire According To Its Indian Preference Policy

All Applicants Are Subject To A Pre-Employment Drug Test

All Positions With The Spokane Tribe Are Subject To A-90 Day Orientation