Position Overview:

• Determining benchmarks and KPIs for the RCM team and assures that all RCM teams are performing at or above expectations.
• Ability to demonstrate a strong understanding of best RCM practices in daily operations.
• Actively seeks out and implements process improvement opportunities.
• Places high emphasis on maintaining an efficient and effective billing model that can sustain or improve financial performance within an evolving landscape.
• Possess strong leadership skills and demonstrate an ability to motivate staff to achieve excellence, reach goals and objectives, and offer professional development.
• Manages relationship and monitors performance of the Company’s outsourced RCM vendor.
• Identifies trends, both positive and negative, that are impacting the success of the RCM function and offers solutions to remedy as applicable.
• Collaborate with Compliance Department to ensure billing practices are in line with government] and payer regulations.
• Monitors effectiveness of billing and collection activity and ensures they are within contracted standards.
• Provides weekly and monthly reporting on RCM KPIs and related performance against goals.
• Monitors denial trends and ensures that denied claims are appealed on a timely basis.
• Works with payers to resolve reimbursement issues.
• Performs collectability analyses for aged accounts.
• Supports CFO and VP of Finance with ensuring revenue integrity.
• Must be adept at analyzing large amounts of data, drawing conclusions, and creating recommendations.
• Must be confident and comfortable presenting to groups.
• Participate in annual department budget process including departmental expenses (ongoing and incremental)
• Review monthly departmental expenses; conduct variance analysis where applicable to identify areas of over-spend and root causes.

Qualifications:

EDUCATION:

• Bachelor’s degree in business, healthcare, or related field is required. A master’s degree is a plus.
• Minimum 10 years of experience in RCM functions (i.e., coding, billing, and collection) with at least five years in a managerial role.

Requirements:

• Experience with analytic tools such as Power BI.
• Experience working in a large, multi-location medical practice.
• Strong knowledge of California’s Workmen’s Compensation billing and guidelines strongly preferred.
• Excellent communication skills both verbal and written. Audiences span the vertical of subordinates to board members.
• Works independently and possesses initiative and resourcefulness.
• Ability to adapt to urgent deadlines or rapidly changing priorities and always maintain composure in high stress situations.
• Proficient in Microsoft Office applications.
• Strong understanding of best RCM practices.
• Position can be hybrid or in office.
• Experience working under a Private Equity investor.
• Familiar with technological changes in the healthcare reimbursement environment.
• Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
• Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed.
• Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Completes tasks on time or notifies appropriate person with an alternate plan. Is consistently at work and on time; Ensures work responsibilities are covered when absent.
• Focuses on solving conflict; Maintains confidentiality; Listens to others; Remains open to others' ideas and tries new things. Writes and communicates clearly and professionally.

$150,000.00 to $190,000.00 Annually

All compensation ranges are posted based on internal equity, job requirements, experience, and geographical locations.

• Generous Medical, Dental, Vision, and Prescription benefits (PPO & HMO)
• 401(K) Plan with Employer Matching
• License & Tuition Reimbursements
• Paid Time Off
• Holiday Pay
• Employee Perks and Discount Programs
• Competitive Salaries!