Chief Revenue Cycle Officer

HEALTH POINT FAMILY CARE INC•Florence, KY

7d•Onsite

About The Position

The Chief Revenue Cycle Officer is responsible for HealthPoint Family Care’s revenue cycle, with the goal of exceeding industry and organizational KPIs, meeting organizational targets, and maximizing revenue and patient and insurance collections in compliance with payer regulations. The role directs daily revenue cycle operations, including Revenue Cycle Managers and non-exempt staff, and develops and enforces policies, procedures, and training materials to meet department goals. The position oversees patient collections and sliding fee scale verification, EDI and the Practice Management System, claims billing and payment posting, payer contracts and fee schedules, staffing and billing goals, denial resolution, claims aging reviews, credits, accounts receivable analysis, and reimbursement trends. It prepares and analyzes monthly reporting and ensures timely month-end close. The role also manages compliance and reporting requirements, supports credentialing and coding audits, oversees Medicaid and Medicare wrap claims, and leads revenue cycle improvements, training, and customer service practices. The Chief Revenue Cycle Officer communicates strategies and performance trends to organizational leadership and staff, coordinates with payers and third parties to resolve claims issues, and supervises and develops staff through feedback, coaching, and evaluations. The role supports continuous quality improvement and innovative use of technology and billing software, and performs other duties assigned by the COO. The position is full-time, day shift, based at HealthPoint Family Care Florence in Florence, Kentucky, with local-only travel.

Requirements

Bachelor’s degree from a four-year college or university, or five years of related experience and/or training.
Demonstrated experience with Microsoft Excel, Microsoft Word, Microsoft Outlook, and Internet and Intranet research.
Knowledge of FQHC billing and operations is expected by the job description.

Responsibilities

Direct daily revenue cycle operations, including Revenue Cycle Managers and non-exempt staff, and develop and enforce department policies, procedures, and training materials.
Manage patient collections and sliding fee scale verification, and support registrar training to achieve the stated time-of-visit collection target and accurately verify eligibility and patient cost-sharing.
Manage EDI and the Practice Management System to support accurate claims billing and payment posting.
Manage payer contracts and fee schedules.
Ensure staffing and plans support organizational billing goals, denial correction and turnaround within 48 hours, claims-aging reviews, and accurate and complete month-end close.
Ensure patient and insurance credits are worked and resolved according to policy.
Analyze accounts receivable, metrics, denial trends, and reimbursement patterns, and develop workplans or projects to maximize reimbursement.
Communicate revenue cycle strategies, trend analyses, and action plans to the CEO, COO, CFO, Practice Administrators, and staff.
Communicate with payers and third parties and submit claims data to resolve outstanding claims issues.
Meet month-end close and reporting deadlines and generate and analyze monthly reports.
Study, recommend, and lead implementation of revenue cycle improvements.
Manage compliance with federal, state, and payer rules, regulations, and reporting requirements, including UDS reporting, quarterly Medicare Credit Balance reports, Medicare wrap applications, escheatment account review, and Medicare bad debt review.
Ensure timely provider credentialing and coordinate with the COO and Credentialing Specialist on facility, provider, and payer credentialing as assigned.
Ensure completion of prospective coding audits under the organization’s Corporate Compliance Policy.
Manage Medicaid and Medicare wrap claims for timely payment and initiate COO or CEO involvement for missing payments.
Maintain knowledge of FQHC billing and operations.
Promote superior service to internal and external customers, including phone and portal patient communications, according to HealthPoint standards.
Develop and lead ongoing revenue cycle, coding, and registration training for providers and staff.
Keep staff informed of department, center, policy, and procedure changes through daily communication and monthly staff meetings.
Retain and develop high-performing staff through timely feedback, coaching, supervision, and evaluations.
Address employee performance problems with effective and timely corrective actions.
Follow applicable regulations and professional standards.
Participate in and support continuous quality improvement and innovative use of technology and billing software, including researching automation of revenue cycle tasks.
Perform other duties and responsibilities assigned by the COO.