Director of Revenue Cycle

Granger Medical•Taylorsville, UT

16d

About The Position

Granger Medical Clinic is one of the largest independent, physician-owned medical clinic groups in Utah. At Granger Medical Clinic, exceptional care comes from all of us. Our mission is to provide exceptional healthcare for patients and their families with a lifetime commitment to quality, compassion and respect. We understand that our personnel play a major role in doing so and we are looking for a Director of Revenue Cycle whose values and mission aligns with ours. The general purpose of the Director of Revenue Cycle Management is to develop and direct the revenue management strategies, tools, and interfaces and to oversee the implementation of these strategies. This position will proactively identify, develop, and execute critical process improvement initiatives to drive best practice performance and favorably impact accounts receivable, cash acceleration, and net revenue.

Requirements

Minimum of 8 years in healthcare revenue cycle management with at least 3 to 5 years in a senior management role (director or above) managing staff of professionals in the revenue cycle environment.
Bachelor's Degree, preferably in Business Administration, Health Administration, Accounting, and/or HIS.
Proficiency with spreadsheet and word processing software; experience with eClinicalWorks working knowledge of healthcare revenue cycle principles and functions; excellent analytical skills; excellent verbal and written communication skills, ability to lead and manage a group of employees.

Nice To Haves

Master's degree preferred.
CPC preferred.

Responsibilities

Participate in the strategic planning and ongoing development of the Revenue Cycle function.
Drive and support hybrid reimbursement models, including process redesign to enable new clinical care models and enterprise-wide technology integration.
Develop, refine, and monitor key performance indicators (KPIs) for Executive Management review, including payer mix, accounts receivable (A/R), collection rates, adjustments, bad debt write-offs, estimated collections, appeal success rates, and other relevant metrics.
Maintain comprehensive knowledge of revenue cycle operations and regulatory requirements across governmental, managed care, and commercial payers.
Serve as the subject-matter expert on regulatory, compliance, and legal requirements related to medical billing and CMS, ensuring adherence to all applicable regulations, standards, and third-party payer directives.
Develop and maintain internal controls to optimize revenue recovery by identifying charge capture, coding, and reimbursement gaps and recommending and implementing corrective solutions.
Monitor accounts receivable performance to ensure aging categories align with established targets and national benchmarks.
Ensure effective management of claim denials, including root-cause analysis and corrective action.
Oversee the identification, management, and appeal of underpayments from insurance carriers.
Ensure payer contracts are current, accurately loaded, and maintained within the contract management system for ongoing monitoring.
Establish and monitor departmental goals and objectives, including productivity standards, for all revenue cycle staff.
Ensure a standardized process is in place for reviewing, approving, and issuing refunds.
Collaborate with registration leadership to maximize workflow efficiencies and ensure accurate and timely entry of demographic and insurance information.
Propose, evaluate, and analyze (including ROI) new technologies and process improvements to enhance revenue cycle efficiency and accuracy.
Assist in the development of annual departmental budgets and ensure operations remain within approved financial parameters.
Ensure staff are educated and trained on new technologies, performance goals, and payer contract requirements.
Establish and lead regularly scheduled revenue cycle meetings to review performance, align strategies, and communicate departmental direction.
Partner with C-Suite leadership to identify payer relationship issues and support contract negotiations and renegotiations.
Ensure timely and accurate reporting and analysis of physician revenue for each provider.
Perform additional duties and special projects related to revenue cycle operations as assigned or directed by Executive Management.