Director of Revenue Cycle Management

This is an in-office based position.

The Director of Revenue Cycle Management is responsible for oversight of the business office, including billing, claims and collections. This position provides direct supervision of the Billing and Collections department staff, enrollment staff, and medical records staff. Responsible for improving and maintaining the integrity of patient billing and reimbursement systems and processes. Specifically, the focus will be to maximize revenue, reimbursement and collections through continuous improvement of interdepartmental communication, systems and operations, and goal setting. Provides regular reports and analysis to executive leadership to drive business strategies and objectives.

Job Description

• Initial priorities will include fine-tuning the operating activities to optimize revenue collections as well as develop key service and support metrics
• Assist with EHR/revenue cycle management software evaluation, selection, and implementation.

• Hands-on management of all billing programs, systems, processes, and third-party vendors to ensure accurate, timely and well-controlled activities related to billing, collections, education, and support
• Monitor, respond to, and communicate changes in billing requirements, regulations, and reimbursement rates, and maintain provider enrollments with payers
• Prepares daily, weekly and monthly RCM reporting metrics to remediate any items outside established KPI including status report of projects

• Effectively implement denial management reduction through process improvements, coordinating direct or indirectly, with internal team and offices to improve workflows and provide training and education
• Maintain understanding and communicates payor policy changes across the market

• Ensure compliance with federal, state, and HIPAA privacy and security regulations as well as with terms of payer contracts
• Ensure staff compliance with coding, PCI, insurance company policy changes

• Collaborate with other departments to maximize training and efficiency
• Counsels and disciplines employees in accordance with department goals and policies

Minimum Requirements

• AAPC-Certified Professional Coder (CPC) Certification required
• Degree in Health Management or equal field preferred.

• 10+ years of managerial experience in healthcare revenue management cycle roles with experience in all phases of the revenue cycle management. Telemedicine Experience preferred
• Experience with implementing practice management software and billing system preferred
• Experience working with managing offshore resources.
• Experience with a large group, growing healthcare organization support
• Extensive knowledge of patient registration, coding, billing, regulatory requirements, billing compliance, business operations, financial systems and financial reporting
• Strong work ethic, attention to detail, knowledge of the claims process, coding, billing, collections and credentialing