Director of Revenue Cycle

This position reports to the Vice President of Revenue Cycle Management, is responsible for leading a 35-person RCM department, and requires a strong leader with the ability prioritize, plan, and direct the team to ensure that all operational revenue functions are aligned and optimized to maximize cash collections and minimize cost to collect.

General Duties

This highly skilled professional will work collaboratively with management and staff. Primary responsibilities include overseeing and coordinating all revenue cycle activities to achieve operational goals and cash flow targets by maximizing reimbursement in a cost-effective manner that follows federal, state and payer-specific billing requirements.

Responsibilities

Revenue Cycle Operations (50%)

• Lead operations of revenue cycle including claims processing, payment posting, accounts receivable collections, denial management, and refunds to ensure accurate and efficient account handling, maximize collections, and effectively manage accounts receivable.
• Develop, evaluate, implement, and revise written guidelines, policies, and procedures using a data-based framework to ensure accurate billing and efficient account collection to consistently meet revenue targets. Establish controls and review mechanisms to ensure procedures are being followed correctly.
• Generate and analyze monthly KPIs and performance metrics to monitor and improve efficiency of billing operations and ensure performance is within established goals and national benchmarks. Lead regular reviews of core billing metrics with team members.
• Ensure timely and appropriate cross-functional problem and customer service escalation; implement feedback loops to timely capitalize on improvement opportunities.
• Keep abreast of revenue cycle and regulatory requirements associated with governmental, managed care, and commercial payers.

Process Optimization (25%)

• Lead process improvement initiatives to reduce the overall cost to collect and ensure that cross-departmental processes are optimized and aligned with all other operations.
• Work with key vendors (EMR, clearinghouse, BPO, etc.) to identify opportunities for improvements to the existing systems or workflows.
• Coordinate the implementation of scalable, sustainable infrastructure to support future growth.

Leadership and Management (25%)

• Manage department staff, including day-to-day supervision as well as performance management, development opportunities, training, and mentorship. Work to create a positive work culture within teams that aligns with other initiatives.
• Oversee onboarding and continuing education for all staff. Ensure mandatory and relevant training is provided to staff in a timely manner to remain current with industry changes.
• Commit to highest level of business and patient confidentiality possible adhering to all HIPAA and security guidelines when accessing and sharing patient information.

Job Requirements/Key Skill Areas

• Proven success in healthcare Professional billing with specific experience in managing and improving the performance of complex revenue cycle functions across multiple platforms and geographies. Strong understanding of evolving healthcare technologies and industry trends and their impact on revenue cycle operations.
• Advanced understanding of all revenue cycle functions, and in-depth knowledge of insurance policies, procedures, and reimbursement practices, including federal, state, and private health care plans. Extensive knowledge of regulatory, compliance, and legal requirements associated with medical billing.

• Strong analytical and problem-solving skills with extensive experience in reporting and analyzing revenue cycle performance trends and improvement opportunities for providers and billers.

• Proven ability to establish clear expectations for excellence in revenue cycle management and hold staff accountable for success, commitment to the development of others, and willingness to coach and mentor people as necessary to promote their personal and professional growth.
• Ability to look for better and more effective ways to organize workflow processes for maximum efficiency, to bring new ideas and new ways of thinking, and be able have them easily understood and adopted by individuals of all levels throughout the organization.
• Strong written and oral communication skills; the ability to present detailed and complicated information clearly and professionally in written and verbal format. Strong computer/technical skills and knowledge.

Desired Background

• Bachelor's degree in business, finance, or healthcare administration required; master's degree is an advantage
• Minimum of 10 years billing experience with a medium to large healthcare organization, preferably professional practice billing
• Minimum of five years managing the revenue cycle with some in a professional practice in multiple states