Director of Revenue Cycle Management

The Revenue Cycle Director is an integral member of the operations team and works directly with the Senior Vice President, MSO Operations to develop strategic plans and ongoing performance improvement initiatives to optimize successful account adjudication, exceptional collections, and high levels of customer service throughout the revenue cycle. This role will lead the Revenue Cycle Manager and Revenue Cycle teams/vendors who support the day-to-day revenue cycle management operations. This position manages processes and provides guidance, direction, and support to encompass all aspects of the revenue cycle, including clinic revenue operations, account follow-up, and denial management. The position provides overall direction regarding the activities of the department and establishes policies and procedures to optimize all facets of patient financial operations. The Revenue Cycle Director will play a key role in the implementation of new processes regarding claims submission and work as a representative of Access Wellness Resources DBA IntraCare Health Center with payers in the group’s market areas and patients who have had care administered by its providers.

Key Job Responsibilites:

• Directly manage the Revenue Cycle Manager and Revenue Cycle teams/vendor (to include offshore partners)
• Serve as leader of Revenue Cycle Function across MSO network, to include TX and AZ practices
• Regularly communicate with, train and provide data to Clinics leadership, providers, and office team members as required to implement and optimize RCM policies and procedures
• Provide consistent and reliable reporting on specified revenue cycle metrics as they relate to organization initiatives and measurable goals
• Develop and implement standardized RCM staffing model, P&Ps to optimize performance, operational efficiency, reimbursement and revenue
• Develop and report RCM KPIs, daily, weekly, monthly and ad hoc
• Develop and implement action plans to address KPI variance to goal
• Directly responsible for Month End Reporting, Close, and Reconciliation
• Supports Physician wRVU reporting and reconciliation
• Support Finance Department with revenue cycle reporting
• Directly responsible for updating and maintaining Charge Master and Fee Schedules within Athenahealth
• Serves as leader on Athena Billing Platform migration team, working with cross-disciplinary group to ensure smooth planning and transition to Athena billing platform and EMR
• Reviews, designs, and implements systematic approaches to maximize revenue and cash flow, while minimizing bad debt, including due diligence and planning for acquired providers and groups
• Create, implement, and train on processes that ensure accuracy and efficiency of patient billing, claims submissions, and collections
• Works cross-functionally to automate and improve every detail of the revenue cycle process ensuring timely revenue, steady collections, and financial viability, making it possible to focus on delivering quality care to patients.
• Provides leadership, organization structure and management for realistic long-range planning as well as day-to-day operations for patient financial services
• Through partnership with the Contracting and Credentialing, addresses regulatory reimbursement and managed care issues related to revenue cycle management
• Work closely with outside vendors/consultants, including offshore support, to sustain revenue cycle management
• Develop high quality metric driven revenue cycle function which values best practices and performance
• Develops budgetary goals and initiates corrective action to address variances
• A decisive leader who holds people accountable while promoting a team philosophy. Can make necessary and perhaps unpopular decisions. Demonstrates commitment to achieving goals while establishing a culture of responsibility and fairness
• Support EMR/PM migrations for acquired providers and groups
• Other duties as assigned

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Qualifications*

• Minimum Education: Bachelor’s degree in finance, accounting, business or related degree required. Master’s degree preferred.
• 10+ years of experience working in Revenue Cycle Management in a healthcare setting
• 5+ years supervisory experience
• Ability to travel between clinics and company locations required
• EMR/PM systems experience with multiple systems/platforms, preference for Athenahealth experience
• Preferred 5+ years Athenahealth experience, building table spaces, maintaining fee schedules, etc.
• Sound knowledge of government and private health insurance payors, contracts, fee schedules, reimbursement methodologies, etc.
• Strong written and verbal communication skills
• Ability to multi-task, function in a fast-moving environment, adapt to process improvement changes and evolving deadlines
• Effective interpersonal skills
• Exceptional time management skills
• Demonstrated ability to work independently
• Must comply with all HIPAA rules and regulations

Job Type: Full-time

Work Location: In person