Salary Range: $150,000.00 to $175,000.00 annually.

By adhering to Connecticut State Law, pay ranges are posted. The pay rate will vary based on various factors including but not limited to experience, skills, knowledge of position and comparison to others who are already in this role within the company.

COVID-19 Considerations Masks are optional for our employees, visitors, patients, vendors, etc. All employees are to have received COVID-19 vaccine including booster, if applicable, and flu vaccine.

PACT MSO, LLC is a management service organization that supports a large multi-specialty practice of providers. The Central Business Office is looking for an experienced Director Revenue Cycle Management to work in the Branford office Monday through Friday from 8:00am until 5:00pm.

Summary

This position manages and oversees the Revenue Cycle Department. The Director is responsible for maximizing the productivity and minimizing the errors of the Revenue Cycle Department using structured auditing and reporting methodologies combined with follow-up training. The Director will assume a strategic and over-seeing role in the billing department to include billing collections, coding, compliance, strategy, planning, management and analysis, and policy development.

Essential Functions

• Research and resolve high level, complex, system and billing issues.
• Oversee the department to ensure accuracy, compliance with regulatory and payer guidelines, coding, and collections in all aspects related to revenue cycle management.
• Provide monthly metrics to COO.
• Monitor and analyze areas of concern, identify trends, and implement corrective actions as needed.
• Collaborate with other departments, such as finance, clinical operations, EHR, and compliance, to ensure alignment and integration of revenue cycle processes.
• 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.
• Maintains appropriate internal controls and safeguards over allowances and write-offs; ensures compliance with department policies to guarantee proper review and approval of adjustments.

Skills and Knowledge

• 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 electronic health records (EHR) preferably EPIC.
• Proficiency in 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

Education and Experience

• Bachelor’s Degree in healthcare administration, business administration, finance or a related field. Master’s degree preferred.
• Minimum of 10 years of progressive experience in healthcare revenue cycle management, with at least 2-3 years in a leadership role.
• Demonstrated experience in electronic health records (EHR), preferably EPIC.
• Certified Professional Coder (CPC), Certified Revenue Cycle Professional (CRCP), or other relevant certifications preferred.
• Minimum of 7 years managing a staff.