As Director of Revenue Cycle, you direct and oversee the overall policies, procedures, objectives, and initiatives of HealthLinc’s revenue cycle activities to optimize the patient financial interaction along the care continuum. This position will review, design, and implement processes surrounding pricing, billing third party payer relationships, compliance, collections, and other financial analyses to ensure that the revenue cycle is effective and accurate. This position manages staff for efficiency and effectiveness, monitors benchmarks and reviews performance statistics. Individual must be able to process large quantities of data to monitor Key Performance Indicators (KPI) and research all barriers to successful revenue cycle management. This position will report to the Chief Financial Officer.

JOB RESPONSIBILITIES:

• Oversight and management of Revenue Cycle Management (RCM) including coding, billing, collections, and denial management as well as financial reporting within the organization functions.
• Ensures claims, denials, and appeals are efficiently processed, and resolving billing-related issues.
• Provides up to date education and training to clinical, coding and billing staff.
• Conducts research and updates a list of all coding procedures.
• Identify organization improvement opportunities based on performance metrics and trends.
• Develops, implements, and oversees billing and coding policies and procedures.
• Conducts ongoing evaluation of billing and coding policies and procedures to optimize efficiency and ensure compliance with regulatory and contract requirements.
• Manage all Revenue Cycle staff including billing supervisors, billers, coders, accounts receivable team; this will include day to day supervision as well as development opportunities, training, and mentorship.
• Perform as a FQHC practice expert for programs on all issues relating to billing.
• Supervise the billing department operations; perform duties such as charge entry, payment posting, reimbursement management, insurance verification, and claim submissions.
• Coordinate with Controller on accounts receivable follow-up practices and procedures.
• Communicate with Managed Care companies acting as a liaison representing the Revenue Cycle Management for all reimbursement issues.
• Conduct monthly analysis of Medicare/Medicaid/Third Party Payers
• Acts as liaison between HealthLinc and Medicare/Medicaid/Third Party Payers
• Actively seeks opportunities to improve revenue cycle and the financial outcomes, engaging staff in the process.
• Review and resolve issues related to claim generation and rejected/denied billings.
• Keeps abreast of all reimbursement billing procedures of third party and private insurance payers and government regulations.
• Audits records to ensure proper compliance and reimbursement for billing of services on a random basis.
• All HealthLinc staff is committed to engage in quality improvement initiatives that align with and support Patient-Centered Medical Home (PCMH).
• Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

REQUIRED QUALIFICATIONS:

Education/Training

• Bachelor’s degree in healthcare administration or related field.
• 10 years’ experience in direct billing and coding or an equivalent combination of education and experience.
• CPT/ICD-10 coding certification.
• EMR software experience required.

Experience

• At least 2-3 years of supervisory experience preferred.

• At least 2-3 years of experience with ICD10, CDT and CPT codes preferred.
• At least 2-3 experience with medical records charts preferred.

Skills/Job Requirement

• Strong organizational and time management skills.
• Excellent written and verbal communication skills.
• Proven ability to work well in a team environment.
• Ability to remain flexible and adaptable.
• Ability to follow HealthLinc policies and procedures.

Technology Skills

• Operate a multi-line phone system and other office equipment including printers, fax machines, etc.
• Basic software skills (Microsoft Office, EHR, phone system monitoring, online sources, etc.)

DIRECT SUPERVISION:

• Biller
• Coder
• Lead Biller