Director of Patient Revenue Cycle

HEALTHTRACKRX INC• US,

10d

About The Position

The Director of Patient Revenue Cycle leads all patient-related revenue cycle activities, spanning vendor and reimbursement operations as well as patient-facing billing and collections. Scope includes managing and providing QA oversight of RCM outsourcing vendors, developing and monitoring key RCM KPIs, providing insight into reimbursement trends, and overseeing the accurate production of patient statements, the customer service call center, and the final adjudication of patient responsibility as payment, adjustment, financial assistance, or bad debt. The Director serves as the key point of contact for RCM outsourcing vendors and works cross-functionally within the Revenue Cycle team as well as with Sales, Commercial, Customer Success, and Finance to ensure billing and collections are accurate, efficient, and customer-friendly.

Requirements

Bachelor's degree in business, finance, healthcare administration, or a related field; or an equivalent combination of education and experience.
Excellent verbal and written communication skills.
Strong problem-solving abilities and adaptability to change.
Demonstrated success building and managing customer/client relationships, including interfacing with Sales, Commercial, and Client Experience leadership.
Experience with RCM applications (Telcor, XIFIN, AMD preferred).
Proficiency with Microsoft Office, particularly Excel, Outlook, and PowerPoint.
Experienced with reporting and analytics (Excel pivot tables, formulas, charts); SQL and database experience preferred.
Experience managing budgets and operating expense targets.
10+ years in healthcare billing; laboratory billing preferred.
3+ years managing outsourced RCM vendors.
Experience overseeing patient billing, collections, and a customer service call center preferred.

Nice To Haves

HFMA Certified Revenue Cycle Representative (CRCR) or equivalent RCM certification preferred.

Responsibilities

Takes an active, hands-on leadership role across Revenue Cycle Management, including customer relationship management and process and project management.
Provides leadership to RCM operations, including QA and reimbursement analysis teams, as well as the patient billing and customer service call center teams.
Serves as the primary point of contact for outsourced RCM vendors and ensures vendors are meeting key KPIs and other performance metrics.
Manages the reimbursement analysis for the patient-related revenue cycle functions and provides direction on metrics and process for delivering key insights to RCM and other Company leaders.
Oversees the customer service call center and the accurate, timely production of patient statements.
Oversees the final adjudication of patient responsibility balances, including determination of payment, adjustment, financial assistance, or bad debt.
Develops short- and long-term patient collections strategies that result in optimal collections while maintaining a positive patient experience.
Interfaces with Sales and Commercial leadership to ensure client satisfaction by making billing and collections processes customer-friendly.
Conducts meetings with Company leadership, as needed, to provide insight into reimbursement trends and initiatives to improve collections.
Develops policies for revenue cycle areas, including but not limited to data entry, payment posting, insurance follow-up, patient collections, and denials management, and coordinates implementation with outsourcing vendors.
Reviews, designs, and implements processes related to billing and collections to ensure cash collections are optimized.
Develops department and team-member KPIs based on industry standards and Company objectives; recommends and reports on performance against key KPIs in the Director's functional area(s).
Monitors and evaluates the work productivity of the billing and patient collections teams; supervises, coaches, and takes necessary action to facilitate achievement of performance targets.
Administers vendor contracts and governance, including scheduled performance reviews, service-level enforcement, and escalation management.
Creates and publishes analytical reports on productivity, billing, collections, and write-offs for monitoring operations and forecasting purposes.
Partners with Finance on cash forecasting, bad-debt and reserve analysis, and month-end close support.
Collaborates with leadership to ensure financial goals and targets are developed appropriately and achieved.
Owns the operating budget for the Director's areas of accountability, ensuring adherence to expense targets and plans.
Develops and manages operational initiatives with measurable outcomes, actively seeking opportunities to improve financial outcomes and engaging staff in the process.
Complies with applicable federal, state, and local legal requirements by understanding existing and new legislation, enforcing adherence to requirements, and advising leadership on needed actions.