Director - Revenue Management

Under the direction of the Chief Financial Officer (CFO), the Director of Revenue Management will lead all program and medical billing within the organization to establish departmental strategic objectives, ensure adherence to quality standards and billing metrics to improve operational efficiency and overall cash flow.

This role will have accountability for projects impacting eligibility, service capture, billing and collections. This position requires a thorough understanding of the accounts receivables process and specifically, the ability to develop a solid understanding of the billing and collection process for YAI programs and medical clinic services, and to identify and implement enhancements and improvements. This role will require substantial organization and attention to detail backed by solid analytical skills.

Key/Essential Functions & Responsibilities

• Responsible for overseeing all revenue from residential, day and clinical programs for YAI in New York, New Jersey and California.
• Oversees the day-to-day operations of the revenue cycle, ensuring adherence to policies and procedures.
• Ensures the operating effectiveness of the revenue cycle from the point of service capture through cash collections.
• Ability to analyze, review and ensure automation of billing and collections processes in the billing systems (e.g. Digital Agency [DA] and NextGen).
• Ensures claims are submitted within required deadlines and that payments are received and posted appropriately.
• Directs and supervises billing and eligibility staff, providing guidance and monitoring staff productivity and performance using established metrics.
• Monitors accounts receivable activity to ensure metrics are within benchmarks and initiates appropriate corrective measures, as needed.
• Oversees and provides input to ensure all billing systems are functional in categories such as dictionary files, data elements, interface and mapping, payor specificity, claims file transmission and electronic remittance posting.
• Oversees payment posting and reconciliation to bank statements with accounting.
• Responsible for management of monthly claims adjustments and bad debt assignments.
• Stays abreast of relevant Federal and State regulations and government and commercial payor regulations for I/DD program billing across all states of operation, as well as medical services provided in clinic.
• Ensures handling of protected health information in a manner consistent with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and maintains knowledge of related requirements.
• Performs all other duties, as assigned.

Minimum Qualification Requirements including education, experience, licensure/certification, etc. and essential physical capabilities (e.g. lifting, assisting lifting, standing, etc.)

• Bachelor’s degree in Business, Accounting, Healthcare Administration or related field; and
• Five (5) years of experience managing the revenue cycle of a healthcare organization similar in size; and
• Ten (10) years of progressively responsible industry experience; or
• Satisfactory equivalent combination of education, experience and/or training.
• Knowledge of receivables software, billing platforms and Electronic Health Record (EHR) systems.
• Strong written and oral communication skills, with the ability to influence at all levels across the organization.
• Detail oriented and highly organized with strong critical thinking and analytical skills.
• Advanced skills with Microsoft Office applications including Word, Excel and Outlook.
• Ability to report on-site to our Manhattan office at least three (3) days per week in accordance with the Agency’s Return to Office Policy.

Preferred Qualification Requirements (desired requirements beyond MQRs above)

• Experience with Evero Digital Agency (DA) or similar electronic medical record system.