Director Revenue Cycle

JOB DESCRIPTION

TITLE: Director, Revenue Cycle

DEPARTMENT: Revenue Cycle

EMPLOYMENT STATUS: Full-Time

FLSA STATUS: Exempt

REPORTS TO: Director of Finance

LOCATION: Administrative Office, some travel to other locations may be required

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POSITION NARRATIVE: Directs and oversees the overall policies, objectives, and initiatives of the Company’s revenue cycle activities. Reviews, designs and implements processes for charge capture, coding, insurance identification, data entry, billing, payment posting, refund processing, and collections. Performs other financial analyses to ensure that clinical revenue cycle is effective and properly utilized. Familiar with a variety of Revenue Cycle Management (RCM) concepts, practices, and procedures within a large multi-site specialty practice environment. Collaborate activities between departments and clients, assemble and analyze daily, weekly and monthly reports to assure proper staffing, workflow and high performance in all areas. The position of Director of Revenue Cycle is a key member of the management team and, as such, this position requires a thorough understanding of a multi-specialty healthcare revenue cycle operations and knowledge of government and third-party payers. Also, knowledge of all functional areas of Revenue Cycle, including patient access, case management, financial counseling, billing, charge capture, coding, medical auditing, denials management, health information management, reimbursement, financial assistance and collections, is required. Further, strong skills in and knowledge of billing, accounts receivable, cash management, health insurance practices, industry regulatory requirements, business office operations, and financial reporting technology are also required. Demonstrated experience with customer service, change management, and continuous quality improvement techniques.

ESSENTIAL FUNCTIONS:

· Manage all Revenue Cycle office matters, including personnel, department resources, budget, monthly reports and other organizational requirements.

· Provide leadership and direction to revenue cycle staff.

· Aggressively and tenaciously pursue complete, accurate and timely payment on accounts receivable.

· Conduct revenue cycle analyses, prepare and review month-end reports and make continual assessments of RCM performance and progress.

· Conduct and lead regularly scheduled multi-disciplinary RCM team meetings to review practice-specific performance, trends and other information.

· Provide constructive feedback to senior management with regard to goal setting, benchmarking, process development and performance.

·· Facilitate effective and timely communication between physician revenue cycle management (RCM) and practice plan leadership, including practice managers and local leadership members.

· Oversee project management of revenue cycle and other billing management systems' enhancements and new systems' installation and implementations.

· Responsible for the design, execution and effectiveness of a system of internal controls which provides reasonable assurance that operations are effective and efficient, assets are safeguarded, and financial information is reliable and compliant with applicable laws, regulations, policies and procedures.

· Participate in special projects upon request of senior management.

· Maintain current knowledge of all applicable federal and state laws and regulations regarding medical billing and business office practices.

· Conduct ongoing departmental meetings, keeping team members informed of goals and performance.

· Conduct one on one meetings with team members and complete annual performance evaluations.

· Perform other duties as assigned or required.

The above is not intended to be an all-inclusive list of essential functions for the job described, but rather a general description of some of the responsibilities necessary to carry out the duties of this position.

SKILLS, KNOWLEDGE & ABILITIES:

Skills:

1. English usage, spelling, grammar and punctuation.

2. Basic research methods and report writing techniques.

3. Excellent verbal, written and interpersonal communication skills.

4. Proficient computer software skills in MS Word, Excel, Outlook, and some Publisher.

5. In Principles of business letter writing and report preparation.

6. Interpersonal skills using tact, patience, respect and courtesy.

7. Establish and maintain cooperative and effective working relationships with others; use discretion in handling difficult situations.

8. Excellent organization and time management skills.

Knowledge:

1. Performance improvement, utilization management and case management functions.

2. Principles and practices of administration, supervision and training.

3. Modern office procedures, methods and equipment, including computers.

4. Pertinent federal, state and local codes, laws and regulations related to REVENUE CYCLE MANAGEMENT.

5. Budget preparation and control.

Abilities:

1. Manage day-to-day operation of the Revenue Cycle Management functions.

2. Coordinate assigned areas of responsibility with other departments and functional units.

3. Research and perform a variety of special projects as assigned.

4. Supervise, train and evaluate staff.

5. Operate office equipment, including computers and supporting word processing, spreadsheet applications and presentation programs.

6. Effectively respond to all situations/incidents using sound judgment and decision-making skills.

7. Read, interpret, apply and explain rules, regulations, policies and procedures.

8. Analyze situations accurately and adopt effective courses of action.

9. Work independently with little direction; plan and organize work; meet schedules and timelines.

10. Prepare reports by compiling and organizing data from a variety of sources.

11. Maintain accurate and complete records.

12. Work confidentially with discretion.

REQUIREMENTS:

Required: Bachelor's degree in Business, Finance, Accounting, Healthcare Administration or related field. Or equivalent experience. A minimum of five (5) years of progressively responsible management experience in a revenue cycle director position within a multi-specialty healthcare organization is required.

Preferred: An advanced degree, ten years’ related experience in outpatient-based specialty patient accounting may be used to replace the Business, Finance, Accounting, Healthcare Administration requirement with a Bachelor's degree in a non-business discipline.

Equal Employment Opportunity Policy Statement

The company shall seek to ensure and provide equal opportunity for all people seeking employment without regard to race, age, race, religion, gender, gender, gender, gender identity, gender, marital status, sexual orientation, military status, national origin, disability, or any other characteristic as established by law.