Job Details
Job Location
Danbury - Danbury, CT
Position Type
Full Time
Job Category
Accounting
Description
Job Summary:
This position reports directly to the Chief Executive Officer, and will be responsible for overseeing and managing all aspects of the revenue cycle process within the organization. This includes billing, collections, coding, compliance, and financial analysis to ensure optimal revenue generation and cash flow. The incumbent will lead a team of revenue cycle professionals, implement best practices, and develop strategies to improve revenue cycle efficiency and effectiveness.
Department Duties/Responsibilities:
Management Functions:
•Develop and implement strategies to optimize revenue cycle performance, minimize denials, and maximize collections.
•Oversee the billing process, ensuring accuracy, timeliness, and compliance with regulatory requirements and payer guidelines.
•Lead and manage the coding team to ensure accurate and timely coding of all patient encounters.
•Monitor and analyze key performance indicators (KPIs) related to revenue cycle metrics, identify trends, and implement corrective actions as needed.
•Collaborate with other departments, such as finance, clinical operations, and compliance, to ensure alignment and integration of revenue cycle processes.
•Provide leadership, guidance, and mentorship to revenue cycle staff, fostering a culture of excellence, accountability, and continuous improvement.
•Stay current with industry trends, regulations, and best practices related to revenue cycle management and healthcare finance.
•Develop and maintain effective relationships with payers, vendors, and other external stakeholders to facilitate revenue cycle operations.
•Participate in revenue cycle audits, compliance reviews, and other regulatory activities as necessary.
•Prepare reports, presentations, and analyses for senior leadership and other stakeholders to communicate revenue cycle performance and opportunities for improvement.
•Ensures quality of work performed by direct reports in area(s) of responsibility.
Administrative Duties:
•Maintains an orderly and efficient office routine.
•Administers established guidelines for prioritizing work activities, evaluating effectiveness, and modifying activities as necessary.
•Reviews and approves all direct reports time cards and PTO schedules.
Patient Flow:
•Establish work flow with the practice management and EMR systems to ensure efficiency
•Access and propose improvements to the patient experience
•Oversee administrative and clinical staff allocation
•Establish/maintain quality efficiency in all functional areas
•Address physician input/complaints with the COO and/or CEO
•Handle/triage patient complaints and incidents and escalate to COO/Physician President as necessary
Qualifications
Physical Requirements:
The physical demands described here are representative of those an individual must meet to successfully perform the essential functions of this job.
Reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions.
•Ability to work in a fast-paced office environment
•Strong sensory skills, such as visual acuity, good hearing, and dexterity
•Ability to stand and sit for periods of time and to move constantly throughout the workday
•Strong speaking and listening skills
•Ability to perform focused work with close attention to detail
•Ability to operate office equipment, including computers, copiers, fax machines, and phones
•Ability to interact with others, both in person and through phone, e-mail, and written correspondence
•This position is classified as having occupational exposure to blood and other infectious materials
•Ability to push, pull, lift, move, and/or carry up to 15 lbs
Education and Experience:
•Bachelor's Degree in healthcare administration, business administration, finance or a related field. Master's degree preferred.
•Minimum of 5-7 years of progressive experience in healthcare revenue cycle management, with at least 2-3 years in a leadership role.
•Strong understanding of healthcare billing, coding, reimbursement and regulatory requirements (e.g., Medicare, Medicaid, commercial payers).
•High degree of composure and interpersonal skills
•Excellent analytical, problem-solving and decision-making skills, with the ability to interpret complex financial and operational data.
•Demonstrated leadership ability, with experience in leading teams, managing projects and driving process improvement initiatives.
•Effective communication skills, with the ability to communicate complex concepts to diverse audiences and build relationships with internal and external stakeholders.
•Proficiency in revenue cycle management software, electronic health records (EHR), and Microsoft Office applications.
•Certified Professional Coder (CPC), Certified Revenue Cycle Professional (CRCP), or other relevant certifications preferred.
•Knowledge of healthcare compliance regulations (e.g., HIPAA, Stark Law, Anti-Kickback Statute) and experience implementing compliance programs is a plus