DIRECTOR OF REVENUE CYCLE MANAGEMENT

Patient Care America • Pompano Beach, FL

78d

About The Position

The Director of Revenue Cycle is responsible for the full oversight of the company’s revenue cycle as it relates to third-party payers and patient billing as well as managing the department staff, processes, and technology. Interprets policies and recommends policy changes. Must be process-oriented, a proven people leader, have technical knowledge, and experience leading a revenue cycle management function in a healthcare environment.

Requirements

• Bachelor's degree in health care administration, finance, or related field.
• Master’s Degree preferred.
• Minimum of five years of proven experience in health care reimbursement and management.
• Significant knowledge of regulatory and operational requirements associated with government billing programs.
• Strong understanding of insurance and billing for various pharmacy payers.
• Extensive knowledge of Medicare/ Medicaid and private payer insurance programs as it relates to prior authorization and medical services, and insurance billing.
• High level of interpersonal skills, problem-solving solving and strong analytic abilities.
• Motivate others to take actions that reflect the company’s core values and department goals.
• Ability to create alignment across several internal departments to achieve business objectives.
• Ability to manage multiple projects/tasks on time and on budget.
• Knowledge of electronic billing processes and procedures such as NCPDP, CPT, HCPCS, and ICD-9 and ICD-10 coding systems, electronic transactions formats, patient billing systems, and Microsoft Office Programs.
• Certified Professional Coder preferred.
• Ability to analyze revenue trends and provide root cause analysis / Excel expert.
• Advanced experience managing RCM & Intake reporting needs (Analyst).
• Excellent ability to effectively communicate with both internal and external stakeholders in written and verbal format.
• Ability to handle numerous requests in a courteous, professional, and collaborative manner.
• Have a positive 'can do attitude'.
• Ability to adapt to changes in a fast-paced environment, while maintaining flexibility to meet deadlines.
• Strong planning and organizational skills with the ability to multitask and prioritize.
• Excellent customer service skills with staff and outside contacts.

Responsibilities

• Design and maintain an efficient and scalable reimbursement process for the organization.
• Coach, counsel, support, and motivate a team of claim resolution and collections specialists to achieve high performance and meet departmental and individual expectations.
• Monitors and evaluates team performance and adherence to Standard Operating Procedures.
• Develop and implement team goals and measures regarding claim adjudication, claim status, billing inquiries, prior authorizations, payment posting, electronic transmittals, and other reimbursement matters.
• Monitor regulatory and contractual changes in reimbursement and ensure communication with management and adherence to applicable billing requirements.
• Ensure reconciliation of AR deposits to AR postings.
• Follow established policies, guidelines, and procedures, including federal and state regulations, to ensure the highest level of operational and regulatory compliance.
• Adheres to HIPAA regulations by maintaining the confidentiality of patient health information (PHI).
• Communicates in a professional and positive manner with all clients and referral sources.
• Participates in internal and external audits.
• Integrates new technologies, tools, or system applications that have the ability to increase production via streamlines processes or procedures into day-to-day processes.
• Become familiar with the functionality of the adjudication and intake departments, identify cross-functional process impacting billing, and coordinate and implement necessary in-service for revenue cycle improvement.
• Keeps management abreast of any issue impacting revenue collections.
• Participate in monthly revenue reconciliation process.
• Establish weekly and monthly billing metrics reports for management.
• Participate in new staff orientation.
• Promotes the concept of patient satisfaction by encouraging high levels of customer service, proficiency, and team pride.
• Other duties as assigned by management.

Benefits

• Competitive pay
• Monthly bonus program
• Generous paid time off
• Paid holidays
• Health insurance
• Life insurance
• Employer-paid Long-term and Short-term Disability
• Wellness
• 401 (k) retirement with company matching program
• Educational assistance
• Career growth
• and much, much more!!

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Bachelor's degree
• Number of Employees: 101-250 employees