Who are we?

Avance Care is in the business of improving the standard of healthcare. By offering specialized, accessible, cost-effective healthcare services, we keep our patients at the center!

Job Purpose: Supports/leads daily Revenue Cycle Department work to compliantly generate the best possible financial outcome for the company at the lowest possible risk through research, collaboration, execution, and structured communication. An Associate Director (AD) helps lead and support the functions of Billing and Collections Team, Customer Service-Contact Center, and Vendor Management Operations. Thus, ensuring successful attainment of department and organizational goals. The AD is instrumental in engaging internal and external stakeholders and strategizing processes and workflow priorities to attain high level of quality outcomes.

Core Responsibilities:

• Support and lead RCM strategic planning, strategy execution, and implementation of standardized processes and procedures to produce predictable high-quality financial outcomes
• Ensure scalable but nimble department structure that supports the organization’s growth plan
• Coach and develop department managers on business plans, staffing, and decisions
• Develop, support, and submit budgetary needs in timely fashion, and monitor and analyze trends to ensure cost effective managing of personnel and resources, adjusting accordingly
• Ensure compliance to each of the programs, as well as others to be identified: (30%)
  • Government and Commercial Payers Contracts
  • Payor Relations and compliant system edits
  • Accountable Care Organization agreements
  • Meaningful use and MIPS/MACRA
  • Coding standards as defined by AMA through CPT, ICD, and HCPCS
  • CPT Category II quality reporting
• Ensure all RCM department tasks are completed with compliance to Avance Care and regulatory standards including, but not limited to: (70%)
  • Account Receivables
  • ERA, Manual Check, and Collection Agency Payment Postings
  • Statement Processing and Refunds
  • Denials Management
  • Customer Service-Contact Center
• Compile and review reports provided by department managers and develop action plans to address negative trends, as applicable
• Compliance planning as it relates to government and private contracts, rules, and regulations, including development and application of compliance policy and procedure
• Support the highest-level of escalation for both patient and payer billing issues
• Effectively recruit, interview, hire, and retain personnel, providing orientation to direct reports. Create an environment of accountability for semi-annual competency assessment of all staff.
• Establish and attend regular meetings with providers, clinical, administrative, or managerial staff to share information and communicate on company issues, as needed
• Align work unit goals with organizational strategic direction. Participate in formation of goals, demonstrate active support of organizational initiatives, and lead change efforts to improve the quality of work.

Qualifications:

• Bachelor’s degree required
• MHA or MBA, strongly preferred
• Minimum 6-8 years of health care billing and/or coding management experience
• 10 years of health care billing and/or coding management experience preferred
• CPC Certification, preferred
• Knowledge of CPT, HCPCS, and ICD-10 coding

What are we looking for?

• Ability to read and interpret documents, specifically medical terminology, insurance, and regulatory terms.
• Ability to write reports, business correspondence, and procedure manuals
• Ability to effectively present information and influence decision making process
• Ability to interact and communicate with a variety of people
• Ability to anticipate and react calmly to emergency situations
• Ability to work with mathematical concepts such as probability and statistical inference; ability to apply concepts such as fractions, percentages, ratios, and proportions to practical solutions
• Ability to define problems, collect data, establish facts, and draw valid conclusions
• Ability to make independent decisions and delegate responsibility and duties
• Ability to follow direction
• Proficient computer skills, including knowledge of Microsoft Office Suite, e-mail systems, and web-based programs
• Ability to handle multiple tasks simultaneously
• Excellent supervisory, managerial skills
• Excellent leadership qualities (including results-orientation, delegation, accountability)
• Knowledge and understanding of how for-profit medical practices run
• Working knowledge of accounting, including ledger, balance sheet, payroll, taxation, etc.