Director of Revenue Cycle (Finance)

Cascadia Health•Portland, OR

1d•$134,763 - $148,251•Onsite

About The Position

The Director of Revenue Cycle oversees the strategy, execution, and integrity of the organization’s revenue cycle and invoicing processes. This pivotal role acts as the primary strategic liaison between internal leadership and our outside revenue cycle. The Director ensures that the vendor meets strict Key Performance Indicators (KPIs), drives clean claim rates, and optimizes cash flow. This position manages internal billing staff while driving operational accountability across external vendor workflows. This position must understand, appreciate, and respect the differences within our Cascadia community. As such, it is expected that this position promotes integrated care, our vision of trauma-informed and person-first approaches and helps create a work environment of acceptance.

Requirements

Bachelor’s degree in healthcare administration, Finance, Business Administration, or a related field
Minimum of five-eight years of progressive healthcare revenue cycle management in an EPIC environment.
Three to five years of FQHC and/or CCBHC revenue cycle management experience.
Operate computer hardware and software at a level needed to effectively perform job functions.
Effective communication and active listening skills.
Demonstrated effective interpersonal and customer service skills.
Advanced knowledge of ICD-10, CPT/HCPCS coding rules, and commercial/government payer regulations.
Advanced data proficiency using tools like Microsoft Excel, Power BI, or Tableau for data extraction.
Extensive understanding of the FQHC and CCBHC billing rules and regs including experience with completing PPS reconciliation with a State.
Must have the ability to travel to multiple locations throughout the Portland Metro area.
Ability to perform CPR, First Aid, and effectively use AED equipment. CPR/ First Aid certifications are required and must remain current.

Nice To Haves

Master’s degree in healthcare administration, Finance, Business Administration, or a related field
A minimum of three to five years of direct experience managing external vendors or outsourced partners.
Three to five years of experience with behavioral health specific billing, such as residential, outpatient, SUD, etc.

Responsibilities

Lead continuous improvement initiatives related to billing operational efficiencies, including designing and implementing customers and internal stakeholders’ reporting, analytics and KPIs to ensure the billing is complete, accurate, current and that revenue is optimized and assured.
Serve as the liaison and point of contact for the external billing partner.
Audit external billing workflows to ensure timely claim submissions and collections.
Monitor vendor Key Performance Indicators (KPIs) including clean claim rates and aging Accounts Receivable (A/R).
Lead performance reviews with vendor leadership to address bottlenecks and system errors.
Enforce contract compliance, financial penalties, and service level agreements (SLAs) for underperformance.
Bridge communication gaps between internal stakeholders and the external partner.
Coordinate with IT to maintain seamless Electronic Health Record (EHR) integrations and data feeds.
Work with the Chief Financial Officer (CFO) to forecast net revenue cash flows and end-of-month financial closings.
Provide feedback to clinical providers regarding documentation gaps flagged by the external billing partner.
Review data analytics from the vendor to identify systemic payer denial trends.
Design and execute root-cause correction strategies to improve front-end revenue workflows.
Streamline the transfer of medical records and prior authorizations required by the partner to resolve claims.
Guarantee that external partner practices follow state, federal, CMS, and HIPAA regulations.
Coordinate third-party audits and compliance reviews alongside the internal Legal and Compliance departments.
Keep the external vendor updated on changes to internal clinical service offerings.
Ensure all data capture feeds correctly into the annual Uniform Data System (UDS) report and Medicare/Medicaid cost reports.
Maximize revenue while ensuring strict compliance with FQHC and CCBHC regulations.
Own and administer Cascadia’s’ Sliding Fee Discount Program in compliance with FQHC & CCBHC requirements.
Develop, maintain, and update the Sliding Fee Scale Policy, discount tiers, and eligibility criteria.
Comply with laws, regulations, policies, and procedures under which the program and company operate.
Comply with and manage relevant Contracts, Memorandum of Understanding (MOU), and Grants.
Ensure the external vendor adheres strictly to HIPAA and patient privacy laws.
Monitor vendor coding accuracy against current ICD-10, CPT, and HCPCS standards.
Conduct quarterly internal audits of sliding fee determinations and discounts applied; correct errors as needed.
Prepare for and support HRSA operational site visits related to sliding fee compliance.
Conduct routine compliance audits on third-party billing and collections activities.
Mitigate compliance risks by monitoring Medicare, Medicaid, and commercial payer updates.
Validate that the vendor applies appropriate modifier usage to minimize audit risks.
Adhere to mandatory abuse reporting laws and HIPAA requirements.
Understand safety regulations and evacuation procedures; participate in regular safety drills in compliance with program policies and procedures.
Complete assigned employee training in compliance with program and company requirements.
Provide guidance, support, and training to staff in alignment with company mission and values.
Participate in all scheduled staff meetings, supervision sessions, and other departmental and company meetings.
In collaboration with program leadership, determine staffing requirements, recruit, hire, and train staff in a manner that supports Cascadia’s mission and maintains strategic growth.
Establish a strong working relationship with contracted revenue cycle company and provide oversight of contract.
Lead the internal revenue cycle team in creation of best practices for billing documentation.
Ensure completion of team documentation as required.
Establish work plans and priorities for revenue cycle staff members, assess the progress of staff members.
Ensure completion of administrative tasks per organizational policies and procedures.
Provide consistent supervision and support for direct reports.
Promote and ensure completion of annual training requirements.
Demonstrate commitment to continuing professional development.
Take the initiative in thought leadership, innovation, and creativity.
Create, model, and maintain a work culture that supports Cascadia’s Values.
Attend and participate in all meetings assigned, including but not limited to staff and team meetings, consultations with staff, individual and group supervision.
Develop and maintain strong relationships with internal and external customers to promote quality and efficiency in Cascadia operations.
Perform other duties as assigned.

Benefits

Generous Paid Time Off Package - Full-time employees earn 6 weeks of PTO in their first year!
Medical and Dental Coverage (begins 1st of the month following hire date)
VSP Vision Discount Plan
403(b) Retirement Plan - Eligible after 60 days with immediate 100% vesting and a 1-to-1 company match up to 3% per pay period, plus the opportunity for an additional discretionary contribution (up to 5%) at the end of the fiscal year.
Flexible Spending Account (FSA) (Medical, dependent care, and transportation options)
Short-Term Disability, Long-Term Disability, and Life Insurance
Paid Bereavement and Jury Duty Leave
Length of Service Award
Voluntary Life Insurance
Supplemental Insurance
Student loan forgiveness options
Employee Assistance Program (EAP)
Bike to Work Reimbursement
Discounted Fitness Memberships
Trauma Support Team