Director of Revenue Management

Director of Revenue Management

Jericho Road Community Health Center is actively seeking a Director of Revenue Management. This position is full-time, within the Medical Billing department, working at our Barton location.

Work with a Purpose

Jericho Road Community Health Center offers the opportunity to be engaged in a movement far larger than any one individual. We believe that we can all be people of positive influence. We influence each other, our clients and patients, our families and communities. We are part of a global team that influences the health and wellbeing of communities internationally. Every day, Jericho Road's mission of caring for communities and advocating for systemic health equity guides us in our collective purpose. We are looking for individuals who share that goal and are committed to that service. As a federally qualified health center (FQHC), our organization's mission is deeply rooted in making fundamental change in the communities we serve, advocating for social justice and meeting people where they are. With global clinics across the world, the impact you make will transcend borders, with opportunities to engage in meaningful work at our Sierra Leone, Goma or Nepal global clinics.

Why Jericho: Jericho Road values both work and life. The option for a flexible 40-hour workweek is possible. Jericho offers competitive pay and benefits including medical (single-high coverage paid in full by employer), HSA, dental, vision, employer paid life insurance benefit, supplemental insurances, tuition discounts, generous paid time off, the opportunity for global travel to our three global health clinics, and loan forgiveness for applicable positions.

Responsibilities:

• Manage and negotiate insurance contract rates annually across all service lines where appropriate working with the Chief Compliance Officer.
• Research opportunities provided by supervisor or Executive Team that will enable the organization to have increased reimbursement streams.
• Support the annual audit and any additional regulatory reporting needs as they relate to revenue.
• Partner with leadership to review and understand key inputs within the revenue recognition process, including obtaining knowledge of various billing systems, auditing procedures, and reports to recommend and construct revenue recognition.
• Support the reporting of monthly statistical analysis, including hosting variance meetings with operations to understand current trends and future impacts.
• Conduct complex analysis on service lines to inform the financial strategies to maximize net revenues.
• Manage and monitor billing and collection processes, operations and controls, ensuring all billing and payment cycles are accurate and timely, in accordance with established internal third-party payer requirements and established JRCHC (Jericho Road Community Health Center) policies.
• Maintain, analyze and report on key revenue metrics and departmental and payer revenue performance indicators, proactively communicating and solving revenue related issues; Identify trends for further review.
• Serve as a liaison between finance department and clinical departments on billing and revenue cycle matters; Enhance awareness of providers on ways to strengthen revenue cycle performance; Train staff on ways to improve revenue generation efficiencies.
• Request, prepare and or maintain reports on billing and collections activities; Develop monthly summary reports for the chief operating officer and senior leadership.
• Perform routine assessments for timely billing processes and optimal collection ratios, providing reports to the chief operating officer and chief financial officer where appropriate.
• Established key collaborative relationships with Medicaid managed care organizations and insurance companies to solve problems and improve reimbursement rates and timeliness.
• Identify patient reimbursement issues, ensuring that claims, denials, and appeals are efficiently processed, and resolve billing-related issues.
• Ability to code diagnoses and procedures correctly and to train others as needed.
• Sound knowledge of health insurance providers, able to navigate different carriers and individual plans more specifically in the FQHC world.
• Oversee monthly close processes, including reporting and account balancing.
• Review financial hardship applications and manage the organization's sliding fee pay scale program compliance in accordance with HRSA (Health Resources and Services Administration) and organization policies and procedures in collaboration with the Chief Compliance Officer.
• Coordinate billing and collection activities, maximizing payments and improving our processes.
• Address medical billing denials from an insurance provider, removing barriers so that patients may be cleared to receive treatment.
• Monitor and manage continuous credentialing compliance in accordance with regulatory bodies and JRCHC policies and procedures.
• Provide supervision, guidance and consultation to the Billing Manager and the Credentialing Manager as they supervise and oversee the respective teams under them.
• Provide supervision and oversee the day-to-day work of the facilitated enrollers.

Qualifications:

• Bachelor's degree in business, Finance, Healthcare Administration or equivalent and a minimum of five (5) years of medical billing/coding experience.
• Minimum of three (3) years in a supervisory role.
• Knowledge of professional fee billing, reimbursement and third-party payer regulation and medical terminology is required.
• Medical coding certification required.
• Demonstrated FQHC coding, billing and revenue cycle management knowledge/experience preferred.
• Medent experience and EHR system knowledge preferred.
• Experience with MCVR and AHCF cost reports preferred.

Salary: $90,000.00 annually. Individual compensation is based on various factors unique to each candidate, including skill set, experience, qualifications, and other position related components.

Job postings are not intended to be an exhaustive list of duties. You will be expected to perform different tasks as necessitated or required by your changing role within the organization and the overall business objectives of the organization.

Jericho Road is an Equal Opportunity Employer. We are an inclusive organization and actively promote equality of opportunity for all with the right mix of talent, skills and potential. We welcome all applications from a wide range of candidates. Selection for roles will be based on individual merit alone.