Healthcare Revenue Management Director

Job Summary:

The healthcare revenue director is responsible for overseeing the revenue cycle operations of a healthcare organization, including clinical and ambulatory surgery center (ASC) billing, coding, collections, and reimbursement. The healthcare revenue director ensures compliance with federal, state, and payer regulations, policies, and procedures, and develops strategies to optimize the patient’s experience and maximize revenue.

Duties and Responsibilities

• Manage and supervise the revenue cycle and credentialing staff, including hiring, training, coaching, evaluating, and disciplining.
• Establish and monitor key performance indicators (KPIs) and metrics for the revenue cycle functions such as days in accounts receivable (A/R), denial rate, cash collections, bad debt, and net revenue.
• Analyze and report on the revenue cycle performance, trends, issues, and opportunities to senior management and stakeholders.
• Develop and implement policies, procedures, workflows, and best practices to ensure accuracy, efficiency, and compliance in the revenue cycle and credentialing department processes.
• Collaborate with clinical and ASC leaders, physicians, payers, vendors, and other departments to resolve revenue cycle issues and improve processes. This would include working with providers on new procedures and vendors to ensure appropriate billing.
• Identify and implement revenue cycle improvement initiatives, such as charge capture, coding accuracy, claim submission, payment posting, denial management, A/R follow-up, and patient collections.
• Ensure compliance with all applicable laws, regulations, standards, and guidelines related to revenue cycle operations, such as HIPAA, Medicare  and private payers.
• Review and manage audits from Medicare and/or commercial carriers as they occur.
• Maintain current knowledge of industry trends, best practices, and regulatory changes affecting the revenue cycle.
• Provide education and training to staff and providers on revenue cycle topics and updates, which includes, but not limited to, onboarding of new physicians, LCDs and Carrier Policies as they develop and/or update.
• Manage the budget and resources for the revenue cycle department.
• Direct oversight of licensing for new and established providers.
• Work closely with CEO and Accounting staff to ensure appropriate metrics and timely completion of month end process.

Management and Leadership Responsibilities:

• All members of Spine Team Texas management are required to submit timely evaluations and competencies for every reporting employee on a 30-day, 90 day and BI-annual basis as stated in policy.
• It is the responsibility of all managers to abide by all Human Resource policies regarding the hiring, terminating, and on-going employment of their reporting employees. 
• Managers are responsible for achieving a high rate of employee satisfaction and performance by maintaining a proactive and responsive employee relationship.  All managers will be responsible for adherence to the operating budget.  Managers are required to act in a manner that is fiscally responsible with company resources.
• Managers are required to attend Managers Meetings and Training/Educational functions as requested by the CEO and Board of Directors.  A manager’s input, direction, and contribution to the growth of the company is essential.
•  Leading by example is always required.  Managers perform in the capacity of company ambassadors to external organizations

In order for Spine Team Texas to meet the goals expressed through the company mission statement, it is imperative that all employees possess the following attributes:

Knowledge – The blending of job related education, skills and experience.

Quantity – Level of satisfactory output generated in position per unit time.

Accuracy – Absence of errors.

Judgment – Capacity to make reasonable decisions.

Innovation – Imagination and creativity used to better position.

Appearance & Habits – Personal habits, grooming, uniform / clothing.

Orderliness – Organization of the individual’s work and work area.

Courtesy – Respect for feelings of others.  Politeness on the job.

Cooperation – Willingness to help others accomplish their objectives.

Initiative – Voluntarily starting projects.  Attempting non-routine jobs and tasks.

Reliability – Dependability and trustworthiness.

Perseverance – Steadfast pursuit of job objectives when faced with unexpected obstacles.

Stability – Even temperament. Acceptance of unavoidable tension and pressure.

Alertness – Ability to quickly understand new information and situations.

Professionalism – Professional actions, communications and attitude.

Team work – Ability to work in a team for the betterment of staff, patients, and the Company.

Observance – Observance of Company policies and procedures.

Attendance – Consistent adherence to work schedule.

Customer Service

All Spine Team Texas employees are required to always maintain the highest level of customer service.  Employees must always speak in a kind, courteous and professional manner when dealing with a patient/customer or co-worker.  Employees are required to fulfill the Spine Team Texas mission of “Offering an Unparalleled Patient Experience!”  All employees must exhibit a spirit of cooperation and positive attitude.  Professionalism is to be always maintained.

Team Concept:

Spine Team Texas was founded on a team concept approach.  To build and enhance the team, each employee must contribute positive interaction, promote value and be a “team-player” not only for their unit or department, but for Spine Team Texas as a whole.

Physical Requirements and Work Environment:

Must be able to sit or stand for long periods of time and work in a well-lit, air-conditioned office environment.  Travel will be required.  Must have the ability to lift a minimum of 25 - 35 pounds.  Must be able to work under pressure.  Tasks involve no exposure to blood or other potentially infectious materials.

Qualifications

• Bachelor’s degree in business administration, healthcare administration, finance, accounting, or related field, or equivalent experience.
• Minimum of 10 - 15 years of experience in healthcare revenue cycle management, including clinical and ASC billing
• Certified Revenue Cycle Professional (CRCP) or equivalent certification preferred.
• Knowledge of healthcare billing systems, electronic health records (EHR), coding systems, payer contracts, and reimbursement methodologies
• Proficient in Microsoft Office applications (Word, Excel, PowerPoint), data analysis tools, and reporting software.
• Excellent communication, interpersonal, leadership, problem-solving, analytical, and organizational skills.
• Ability to work independently and collaboratively in a fast-paced and dynamic environment.
• Spine Team Texas Attributes