Sr. Director, Revenue Cycle Management
Apply NowCompany: AEG
Location: Alton, IL 62002
Description:
About the Job
The Sr. Director, Revenue Cycle Management is responsible for leading Revenue Cycle Management (RCM) Operations - insurance payer billing, patient billing, payment posting, aging, collections, write-offs/adjustments and clearinghouse management for all types of vision claims including medical, routine vision and specialty services. Business lines will include vision plans, health plans, Medicare, Medicaid, local plans, safety plans and discount plans. In addition, this position will provide RCM billing oversight for the transition and integration of newly acquired practices onto AEGs common systems platform. The Sr. Director, Revenue Cycle Management works closely with the Sr. Director, Managed Care Operations and cross-functionally with Integrations, IT, Merchandising, Marketing, Legal/Compliance, Operations, Professional Services, Call Center, Accounting and Finance teams.
Requirements
Benefits
*Benefits applicable to full Time Employees only.
Physical Demands
Benefit Packages
Benefits: 401(k) with Match, Medical/Dental/Life/STD/LTD, Vision Service Plan, Employee Vision Discount, Program HSA/FSA, PTO, Paid Holidays *Benefits applicable to Full Time Employment only*
The Sr. Director, Revenue Cycle Management is responsible for leading Revenue Cycle Management (RCM) Operations - insurance payer billing, patient billing, payment posting, aging, collections, write-offs/adjustments and clearinghouse management for all types of vision claims including medical, routine vision and specialty services. Business lines will include vision plans, health plans, Medicare, Medicaid, local plans, safety plans and discount plans. In addition, this position will provide RCM billing oversight for the transition and integration of newly acquired practices onto AEGs common systems platform. The Sr. Director, Revenue Cycle Management works closely with the Sr. Director, Managed Care Operations and cross-functionally with Integrations, IT, Merchandising, Marketing, Legal/Compliance, Operations, Professional Services, Call Center, Accounting and Finance teams.
- Develop and manage a staff of RCM associates. Personnel responsibilities include recruiting, hiring, training, PTO requests, performance management, conflict resolution and employee development
- Work directly with the VP, Revenue Cycle Management on strategic planning for the department including short- and long-term objectives
- Partner with the Sr. Director, Managed Care Operations to ensure successful execution of department responsibilities
- Work with claims clearinghouse services as necessary to confirm high functionality
- Implement and use automated/electronic transaction solutions whenever possible. Work closely with in-house IT partners to continue to improve automation and connectivity in claims billing, to become more efficient while improving accuracy and timeliness
- Manage teams and resources to:
- Ensure all claim billings are clean, accurate and timely filed
- Develop and maintain scrub processes for claims based on claim standards, payer requirements and contracting/credentialing status rules
- Post claim payments efficiently, timely and accurately. Resolve discrepancies immediately
- Constantly review and analyze claims collections and aging reports to identify opportunities and trends
- Research open claim balances and resolve open and partially paid claims
- Re-bill payers or balance bill patients as necessary
- Perform adjustments and write-offs as appropriate
- Work with IT to develop and enhance back-office workflow tools and reporting
- Collaborate closely with Managed Care Operations team related to any discrepancy findings to determine possible payer communications, set-up changes or training opportunities
- Ensure all field legacy RCM functions continue during the transition phase (close through ALE launch + 90-120 days) until virtually all accounts receivable balances are collected
- Collaborate with Integration, Accounting and RCM Operations to enable migration of current RCM legacy platform practices and the integration of newly acquired practices into AEG Vision common platform
Requirements
- A college degree is required and a strong track record of leadership and achievement in the healthcare industry is critical
- At least ten (10) years' experience managing a diverse staff in cross-functional operational roles
- Revenue Cycle Management experience is required, vision industry specific is strongly preferred
- Experience with system migrations and integrations is preferred
- Previous experience with strategic planning and budgeting a plus
- Effectively collaborates, gains alignment and leads cross-functional teams across the organization and shares information with others via strong written and verbal communication
- Works well under pressure, meets deadlines, is very organized and responsive
- Manages through ambiguity, uses sound judgment and creates clarity where possible
- Strong leadership, people, communication and project management skills are required
Benefits
- 401(k) with Match
- Medical/Dental/Vision/Life/STD/LTD
- Employee Vision Discount Program
- HSA/FSA
- PTO
- Paid Holidays
*Benefits applicable to full Time Employees only.
Physical Demands
- This position requires the ability to communicate and exchange information, utilize equipment necessary to perform the job, and move about the office.
Benefit Packages
Benefits: 401(k) with Match, Medical/Dental/Life/STD/LTD, Vision Service Plan, Employee Vision Discount, Program HSA/FSA, PTO, Paid Holidays *Benefits applicable to Full Time Employment only*