Director of Revenue Cycle

Job Summary :

The Revenue Cycle Director directs and oversees the overall policies, objectives and initiatives of an organizations revenue cycle activities to optimize the patient financial interactions along the care continuum.

Functions and Duties :

• Reviews, designs and implements processes surrounding admissions, pricing, billing, third party payer relationships, compliance, collections and other financial analyses to ensure that clinical revenue cycle is effective and properly utilized.
• Tracks numerous metrics related to the patient engagement cycle including record coding error rates and billing turnaround times to develop sound revenue cycle analysis and reporting.
• Manages relations with payers and providers to generate high reimbursement and a low level of denials.
• Establishes and maintains all billing guidelines and objectives to ensure timely and accurate invoicing to clients, as well as minimizing collections issues.
• Maintains receivable objectives by understanding client contractual needs, state regulations and billing guidelines.
• Reviews and resolves major account problems; resolves extraordinary situations involving outstanding billing, payments, or adjustments to patient’s accounts.
• Establishes policies and procedures as they relate to the billing and collections processes.
• Understands how department transactions impact monthly financial statements and provide account receivable reserve estimates to the accounting department.
• Monitors cash, insurance and self-pay payment posting.
• Oversees the staffing and management of the Patient Access and Patient Financial Services departments within the established values, procedures and guideline of the department, the company and all applicable laws and statues.
• Supports margin objectives in efforts to obtain maximum reimbursements and resolve reimbursement issues.
• Develops and maintains policies regarding write-offs, credits and general bad debt determinations.
• Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications and establishing personal networks.
• Assesses and responds to organizational and customer’s needs with innovate programs to ensure customer satisfactions. Implement patient friendly billing guidelines.
• Participates in revenue cycle, denial management, charge master and access management work teams.
• Continuously reviews process flows to ensure optimal performance and exceptional customer experience.
• Drives workflow, processes and procedures related to Patient Access, Financial Counseling, Business Office and Physician Billing operations.
• Assists in the development and enforcement of corporate policies regarding account adjustments and write offs in collaboration with CFO, Controller and Department Administrators.
• Implements institution-wide projects, as assigned, for realizing improvement opportunities in revenue cycle operations.
• Performs all other duties as assigned.

Minimum Qualifications :

Education

Experience

Certifications, Licenses, and Registrations

Skills and Abilities

Physical Demands :