Revenue Cycle Director
About The Position
The Director of Revenue Cycle Management (RCM) provides strategic leadership and operational oversight for all aspects of the end-to-end revenue cycle, including Patient Access, Insurance Verification, Charge Capture, Medical Coding, Claims Submission, Denial Management, Payment Posting, Collections, and Patient Financial Services. This position ensures that all billing, reimbursement, and payment processing activities are completed accurately, timely, and in full compliance with federal and state regulations, payer requirements, and organizational policies. The Director of Revenue cyle Management is accountable for maximizing net revenue, , improving the cost-to-collect, minimizing bad debt, reducing denial rates, and optimizing accounts receivable performance across all ambulatory clinic locations.
Requirements
- College degree highly preferred.
- An ideal candidate will have at least 5-7 years Revenue Cycle or Business Office experience.
- Must have Management experience (Healthcare Management experience highy preferred)
- Strong verbal and written communication skills required.
- Ability to exercise good judgment and positively influence and lead others, including handling confrontations with poise and efficiency.
Nice To Haves
- Athena experience is preferred.
Responsibilities
- Manage payor relations and providers to generate high reimbursement rates and lower denial levels.
- Develops integrated revenue/expense analyses, projections, reports and presentations.
- Conduct ongoing trend analysis on third-party payor payment levels to ensure reimbursement in accordance with allowable amounts outlined in agreements and contracts.
- Coordinate with other department leaders to ensure proper billing practices (coding, pricing, adjustments, client communications, etc.) impacting collections.
- Prepares and presents monthly, quarterly, and annual RCM performance reports for leadership.
- Identify rejects, denial and missed opportunities and resolve discrepancies.
- Maintain internal controls, policies and procedures consistent with state and federal law, compliance plans and HIPAA.
- Collaborate with the C-Suite to facilitate contract negotiations and renegotiation's of payor contracts.
- Communicates with third-party payers, operations, and other internal and external departments regarding maximization of revenue and charge optimization.
- Collaborates with operations and revenue management for the analysis and support of daily, weekly, and monthly reports to assure proper workflow in all areas.
- Monitors current and emerging reimbursement issues, regulations, and reporting requirements.
- Facilitates in-depth understanding to both technical and non-technical audiences while fulfilling business needs
- Create process improvement initiatives that maximize the performance and integrity of revenue cycle activities.
- Recruit, develop, and manage revenue cycle staff; establish performance standards and conduct regular evaluations
- Drive process improvement initiatives and technology adoption to improve efficiency, accuracy, and performance across all revenue cycle functions.
- Manage and implement new the fee schedule and allowable schedules annually.
- Perform all other duties as reasonably assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
