Director of Revenue Cycle Management

Marin Community Clinics•Novato, CA

3d•$152,070 - $178,471•Hybrid

About The Position

Marin Community Clinics (MCC), a Federally Qualified Health Center (FQHC) founded in 1972, is a multi-clinic network providing integrated primary care, dental, behavioral, specialty, and referral services to nearly 40,000 individuals annually in Marin County. The Director of Revenue Cycle Management (DRCM), reporting to the CFO, will lead and enhance the organization's revenue cycle operations to promote financial viability. This role is responsible for developing and implementing patient-friendly workflows and processes that maximize revenue, improve efficiency, and ensure regulatory compliance. The DRCM will also lead and develop a service-oriented revenue cycle team, ensuring operations are performance-driven, data-informed, and aligned with strategic objectives and budgets.

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.
Fulfill immunization and fit for duty regulatory requirements.
Prolonged periods of sitting at a desk and working on a computer.
Use of mouse, keyboard and headset.
Must be able to lift up to 15 pounds at times.

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 to maximize revenue and prevent errors, including patient registration, authorization, eligibility, benefits verification, charge entry, coding, claim submission and management, accounts receivable management (denials, bad debt, collections, appeals), and payment posting/credit balance resolution.
Cultivate and build effective relationships across the organization to optimize the 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 MCC.
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 the 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 with necessary competencies.
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.