Director of Revenue Cycle Operations & Systems

Job Purpose and Overview:

The Director of Revenue Cycle Operations & Systems assumes a pivotal leadership role responsible for overseeing the daily operations of the billing and collections departments, as well as the associated systems encompassing data analytics. This role encompasses the supervision of crucial areas such as Credentialing, Demographics, Coding, Charge Entry, Payment Applications, and Accounts Receivable & Patient Financial Services. Furthermore, this position is tasked with cultivating and managing strategic relationships with key stakeholders, including medical professionals, insurers, patients, and senior leadership.

Minimum Qualifications:

• A bachelor's degree in accounting, business, finance, business administration, or an allied health field, accompanied by a substantial background in revenue cycle management.
• Preferred possession of CPC Certification.
• Exemplary attention to detail and strong organizational skills.
• Exceptional customer service aptitude, with the ability to thrive under pressure.
• Proficiency in computer applications, particularly the Microsoft Office suite, with a focus on Excel.
• Demonstrated capacity to multitask, meet deadlines, and excel in a fast-paced work environment.
• Competence in both independent work and collaborative teamwork.
• Exceptional written and verbal communication skills.
• Successful completion of a criminal background check.

Preferred Experience:

• Eight (8) to Ten (10) years of experience in healthcare roles, with a noteworthy tenure (5 to 6 years) in supervisory positions related to billing and collections.
• Prior experience in healthcare industry accounts receivable.
• CPC certification is highly preferred.

Key Responsibilities:

The incumbent will be responsible for the following essential functions:

• Directly supervise revenue cycle departments, including credentialing, coding, billing, cash reconciliation, and collections from payers and patients.
• Manage revenue cycle activities to attain performance benchmarks related to credentialing, charge capture optimization, claim rejection & denial rates, DSO (Days Sales Outstanding), and overall collections.
• Oversee revenue cycle activities to achieve benchmarks related to posting dates, reconciliation, posting accuracy, ERA/EFT (Electronic Remittance Advice/Electronic Funds Transfer) percentages, and payment variances.
• Foster and maintain critical working relationships with clients and payers, ensuring accurate billing and collections while serving as an escalation point and a subject matter expert.
• Proactively identify opportunities for improved reimbursement and address any issues related to payer and patient collections across all markets.
• Independently manage the repository of payer contracts, ensuring it remains up-to-date and encompasses new add-on practices.