Director of Revenue Cycle

TrueCare • San Marcos, CA

101d • $102,346 - $158,636

About The Position

The Revenue Cycle Director is responsible for oversight of the organization’s revenue cycle. This includes short- and long-term planning; coordinating workflows of clinic front desk, billing and coding staff; managing the revenue cycle including revenue received, daily coding volumes, productivity, turnaround times and other key indicators; creating and recommending action plans and responses to improve revenue cycle operations and implementing these plans; and generating reports. The Revenue Cycle Director is also responsible for the development, implementation and administration of all policies and procedures relating to the revenue cycle and the practice management system.

Requirements

• Bachelor’s degree in finance or related field or an equivalent combination of related education and relevant professional experience.
• At least seven (7) years’ managing revenue cycle activities for a community clinic or Federally Qualified Health Center (FQHC).
• At least five (5) years’ management experience.
• Experience with various revenue cycle operations from scheduling, and pre-registration to billing and collection of Accounts Receivables.
• Working knowledge of CPT and ICD10 codes, third party payor reimbursement, billing and insurance regulations, medical terminology, insurance benefits and appeal processes.
• Experience working with Epic practice management system.
• Proficiency in Microsoft Office Suite products, including Outlook, Word Excel (advanced), and PowerPoint.

Nice To Haves

• Master’s Degree preferred.

Responsibilities

• Manage the revenue cycle functions to ensure that the organization is being paid appropriately for all services provided in accordance with regulatory and contractual requirements.
• Ensure compliance with coding guidelines and reimbursement requirements to facilitate attainment of accounts receivable (AR) targets.
• Develop policies, procedures and processes related to revenue cycle functions, including registration, fee schedules, pricing, billing, collections and other financial analyses.
• Direct and oversee the overall policies, objectives, and initiatives of the organization's revenue cycle activities to optimize the patient financial interaction along the care continuum.
• Coordinate, monitor and manage third party contracts and participate in third party payer negotiations.
• Maintain relationships with third party payers to resolve payment issues and address operational issues associated with each contract.
• Provide oversight of provider insurance plan enrollment to ensure that provider participation with payers is accurate and completed without delay.
• Develop and monitor receivable management reports such as aging analysis, denial reports, and payment exception reports and collections performance.
• Develop and implement action plans to accelerate cash flow and maximize reimbursement in accordance with contracts and regulations; and provide recommendations based on analysis and reports.
• Prepare billing statements for submission to Medi-Cal, Medicare and third-party payers.
• Provide direction to clinician training to support maximum efficiency in the revenue cycle ensuring that providers are maximizing billing potential when coding procedures.
• Create and provide a monthly report to the CFO and COO outlining billing deficiencies with recommendations for correction and/or process improvements; coordinate and lead a monthly revenue cycle meeting to discuss current billing issues.
• Collaborate with information technology resources and operational leadership to identify E.H.R.-related workflow issues that impact the effectiveness of the revenue cycle processes; identify and help to implement solutions.
• Interface with key revenue cycle stakeholders including clinical and operational leadership to identify workflow issues and barriers to an effective revenue cycle process; and recommend and help implement solutions.
• Proactively coordinate and oversee new facility licensing and certification to ensure maximum reimbursement rates, fees, and timely reimbursement for services.
• Evaluate the training needs of the billing and coding team and plan, develop and conduct training programs as needed.
• Provide oversight of completion of external audits; implement changes, as appropriate, based on findings; report audit results and corrective action plan, if applicable, to the NCHS Corporate Compliance Officer.

Benefits

• The pay range for this role is $102,346 - $158,636 on an annual basis.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Bachelor's degree
• Number of Employees: 501-1,000 employees