Director, Revenue Cycle Management

​WellNow Urgent Care is here to help our patients get well. Founded in 2011, we have quickly grown, with over 180 locations across New York, Pennsylvania, Illinois, Indiana, Wisconsin, and Michigan. Putting people at the heart of everything we do we focus on providing the best care for both our patients and our employees. ​

WellNow is a part of TAG – The Aspen Group (TAG) is one of the largest and most trusted retail healthcare business support organizations in the U.S. and supports over 20,000 healthcare professionals and team members at more than 1,300 health and wellness offices across 48 states in four distinct categories: dental care, urgent care, medical aesthetics, and animal health. Working in partnership with independent practice owners and clinicians, the team is united by a single purpose: to prove that healthcare can be better and smarter for everyone. TAG provides a comprehensive suite of centralized business support services that power the impact of five consumer-facing businesses: Aspen Dental, ClearChoice Dental Implant Centers, WellNow Urgent Care, Chapter Aesthetic Studio, and AZPetVet. Each brand has access to a deep community of experts, tools and resources to grow their practices, and an unwavering commitment to delivering high-quality consumer healthcare experiences at scale.

The Director, Revenue Cycle Management will lead revenue management and drive strategies for maximizing payment and be responsible for the continuous improvement and streamlining of all systems and processes. They will determine appropriate and effective performance metrics and staff requirements for the RCM function to run with efficiency, accuracy and outstanding customer service. They will assist and participates in the network objective of aggressive revenue growth including marketing efforts and actively research and remain apprised of industry/regulatory trends and best practices in order to ensure Company leadership in revenue cycle management. The successful candidate will develop written procedures for the centralization and standardization of the revenue cycle; continually monitor changes in workflow as needed to improve productivity and develop relationships with governmental bodies, managed care organizations and other business partners. They will manage the collections cycle and write-off process ensuring write-off in a timely manner after thoroughly exhausting all efforts, play an active role in the selection, recommendation, maximization and implementation of software and monitor compliance with all third party payer regulations, exception handling, appeals and denials. This individual will maintain confidentiality in compliance with HIPAA regulations, monitor the effectiveness of all revenue cycle activities to insure revenue is maximized within regulatory guidelines and assure continuing compliance. Overall, the successful candidate will provide a high level of strategic and operational support to ensure seamless execution of claims and collections operations, develop, implement and monitor policies and protocols related to provider verifications and ensures compliance with organizational standards. This role requires current, in-depth knowledge of governmental and commercial insurance rules and regulations.

Essential Job Functions:

• Manage and/or assist in key department or cross-functional projects.
• Developing a strong sustainable team by attracting, developing, rewarding, and retaining talent.
• Motivates diverse teams by exemplifying the company vision, mission, values, and culture.
• Directs the development of training critical to the team’s success.
• Forecasts department staffing needs and manages staffing levels, with a strong focus on developing and retaining strong talent. Develops and manages the department financial budget.
• Works across the organization (field teams and practice support teams) to develop best-in-class practices that support best-in-class results.
• Collaborate with Aspen Dental Management’s shared services functions that directly or indirectly support the revenue cycle function for Five Star.
• Develops the service practices required to meet the high expectations of the organization.
• Manage the EMR system and vendor, ensuring functionality and efficiencies are optimized. Effectively solve system issues internally or with third party vendor and extract data and perform analysis as needed.
• Ability to make recommendations for solutions that meet organizational goals.
• Supports the maintenance and inputs of the monthly Accounts Receivable bad debt allowance and contractual allowance, and provides insights and commentary on specific collection issues.
• Assist in month end close and reporting responsibilities, systems close and maintenance, report reconciliation and review.
• Leads through continuous improvement to ensure optimal processes and controls are in place and aligned with Company growth.
• Develop and lead effective cross-functional provider credentialing and enrollment processes.
• Prepares information reports and analysis of system data utilizing ERM software and other tools for monthly management reporting. Present monthly RCM reporting to management.
• Analyzes Profit and Loss statements and Accounts Receivable Agings, recommends changes in course of action.
• Creates and manages department key performance indicators / metrics to monitor the effectiveness of collection efforts and timeliness of insurance billings.
• Leads weekly Billing/ Payer meetings with status updates on projects, payor issues and general reporting on receivables.
• Monitors industry and regulatory trends, develop and communicate plans to manage the impact of future health care reform.
• Participate in third party payer negotiations, review contracts with payers, oversee resolution of contract payment issues, and assisting in collection efforts.
• Vendor management, from sourcing, recommendations, negotiations, implementation, and auditing of contracted pricing arrangements.
• Assist in external financial statement audits, insurance audits/inquiries, and internal compliance requests.
• Committed to the specialty of Urgent Care, with a focus on serving our communities with quick, convenient and quality care with continued clinical and patient experience training.

Minimum Job Qualifications:

• 7 years’ experience with in-depth working knowledge of medical billing and the insurance industries including reimbursement, EDI and electronic remittance processing.
• Bachelor's degree required. Finance and/or advanced degree preferred.
• Experience in a growing healthcare environment.
• Strong working knowledge of the end-to-end revenue cycle from: charge master; health information; patient registration; coding; insurance verification; billing and claims processing; accounts receivable management; adjustments; remittance processing; and collections.
• Strong working knowledge of EMR and other systems and technology that drives efficiency, productivity, and cost effectiveness.
• Proven career progression with increasing levels of project experience and responsibility.
• Proficient in Microsoft Office, including Excel, Word, and PowerPoint.
• Knowledge of basic accounting principles.
• Excellent oral and written communications, interpersonal and organizational skills.
• Ability to read and analyze contracts.
• Financial analysis of Revenue Cycle protocols.
• Multiple project leadership, business partnering and cross department/matrix collaboration.
• Self-management abilities and sound business judgment.
• High level of experience and expertise with related software.
• Flexibility to support and to adapt to change.

Annual Pay Range: $155-175k, plus bonus opportunity

A generous benefits package that includes paid time off, health, dental, vision, and 401(k) savings plan with match

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