Director of Revenue Cycle Management

Marin Community Clinics•Novato, CA

20h•Onsite

About The Position

Marin Community Clinics, founded in 1972, is today, a multi-clinic network with a wide array of integrated primary care, dental, behavioral, specialty and referral services. As a Federally Qualified Health Center (FQHC), we provide vital health services to almost 40,000 individuals annually in Marin County. The Clinics regularly receive national awards from the Health Resources and Services Administrations (HRSA). Our Mission is to promote health and wellness through excellent, compassionate care for all. The Director of Revenue Cycle Management will direct a continually improving and robust patient revenue cycle management system. Under the direction of the CFO, the Director of Revenue Cycle Management (“DRCM”) will enhance and improve revenue yield, year over year. The DRCM is responsible for promoting financial viability of Marin Community Clinics (“MCC”) by effectively managing all aspects of the organization’s revenue cycle operations. This role will lead the organization-wide patient-friendly workflows and processes throughout the revenue cycle that maximize revenue, enhance efficiency and productivity, and support regulatory compliance. In addition, this role leads and continually develops an accountable and service-oriented revenue cycle team that is aligned in shared goals, outcomes, and mission. As a champion of optimization, measurement, and efficiency, this role will ensure revenue cycle operations are performance-driven, data informed, and structured to meet strategic objectives within established budgets and timeframes.

Requirements

Bachelor’s degree in Business, Finance, Accounting, Health Management or related field, or equivalent experience required.
Five years of experience managing the patient revenue function required.
Ability to function effectively as a member of an inter-professional team.
Ability to assess competency, manage, and develop exempt and non-exempt staff.
Ability to assess the functionality of all areas of the patient revenue cycle.
Ability to use data and information technology to manage and improve the patient revenue cycle function.
Excellent communication skills, both written and verbal.
Exceptional organizational, time, and project management skills.
Culturally competent and sensitive to the needs of a multi-cultural workforce and patient population.
Ability to effectively present information and respond to questions and requests from patients, co-workers, and others as necessary.
Ability to add, subtract, multiply, divide in all units of measure, using whole numbers, common fractions and decimals.
Reasoning Ability: Ability to recognize problems, collect data and establish facts.
High level of computer literacy and proficient in MS Office (Word, Excel, Outlook, etc.), electronic medical records, and any additional third-party software needed to support the revenue cycle function.
Fullfill immunization and fit for duty regulatory requirements.

Nice To Haves

Master's degree (MBA or MHA) preferred.
Seven or more years of experience managing the patient revenue function, multi-site, Federally Qualified Health Center in California strongly preferred.
Certified Revenue Cycle Specialist/Professional/Executive certification strongly preferred.
Certified Coder Certificate strongly preferred.
Bilingual in English and Spanish, both written and verbal preferred.

Responsibilities

Develop and operationalize accurate, well documented, timely and compliant revenue cycle policies, procedures and systems in all applicable areas that maximize revenue and prevent errors, including: Patient registration, authorization, eligibility, benefits verification. Charge entry and Coding. Claim submission and management. Accounts receivable management, including but not limited to: denials, bad debt and collections, appeals processing. Payment posting, credit balance resolution.
Cultivate and build effective relationships across the organization to optimize Patient Revenue Cycle. In collaboration with the COO and Front Office leadership, ensure optimal function of front-end revenue cycle elements, including patient registration, documentation, and upfront patient collections.
Communicate changes in revenue cycle requirements, regulations, and reimbursement.
Educate staff across the organization on how their functions impact the organization’s revenue cycle, including its bad debt, cash flow, and accounts receivable, as well as customer loyalty and the overall financial health of PHC.
Report key revenue metrics monthly and explain incidents and/or trends immediately to all team members and all levels of management as appropriate.
Ensure compliance with federal and state laws, pertaining to revenue cycle by analyzing internal policies, and implementing appropriate charges.
Analyze, understand and negotiate excellent third-party contracts in terms of cost, volume and reimbursement rates.
Maintain expertise on Medi-Cal, Medicare, and all CMS rules, regulations and processes for FQHCs in California.
Take timely/urgent action when any expected payment is not received.
Implement systems to prevent untimely payments/receipts and denials and develop and implement action plans to resolve.
Monitor, respond to, and communicate changes in revenue cycle requirements, regulations, and reimbursement.
Hire billing and coding staff and necessary competencies present.
Provide staff with clear and effective training to improve performance, as needed.
Hold staff accountable to clear and measurable productivity and accuracy metrics.
Develop and implement systems and business controls to monitor staff.
Ensure staff are operating under all applicable compliance standards.
Direct and supervise daily activities and workflows of registration and financial counseling staff to ensure that work areas are staffed appropriately, breaks are taken and overtime is utilized appropriately.