Director RCM Operations

Omega Healthcare Solutions

5d•Remote

About The Position

The Director of RCM Operations leads and coordinates all client service and operational activities for assigned accounts, ensuring high client satisfaction and strong performance outcomes. This role oversees end-to-end Revenue Cycle Management (RCM), including front-end, mid-cycle, and back-end functions, with working knowledge of Accounts Receivable (AR), while monitoring KPIs, driving process improvements, and ensuring revenue and cash collection goals are met. The position requires strong P&L and operational performance management, the ability to proactively resolve client issues, and excellent rapport-building and communication skills. A solid understanding of hospital coding and professional (ProFee) coding is mandatory for the success in this role.

Requirements

Bachelor’s degree in business/HIM or equivalent plus advanced relevant formal training.
Expertise in End to End RCM, with strong focus in AR and Coding is required
Strong knowledge of hospital coding and professional (ProFee) coding is required
Experience working with/managing global resources (India, Columbia, Philippines, etc.)
Minimum 4 to 6 years of experience in Revenue Cycle and HIM Leadership Roles, including patient access, scheduling, prior authorizations, coding, CDI, billing and/or insurance follow-up
Experience working with scheduling, coding, and billing or collections system and standard office software products required.
3+ years previous first-line management experience.
Ability to prioritize and multi-task in a fast paced, changing environment.
Demonstrate strong organizational skills and be detail oriented.
Ability to self-motivate and self-direct.
Ability to achieve set goals and deadlines.
Demonstrate strong time management skills.
Demonstrate excellent leadership, mentoring, and interpersonal skills.
Demonstrate the ability to analyze and problem solve.
Demonstrate strong commitment to team environment.
Ability to collect, create, and research complex or diverse information and act/plan accordingly.
Experience budgeting and monitoring financial indicators.
Ability to maintain professionalism when interacting with internal and external customers.
Ability to draft presentations using PowerPoint and present information to large groups.
Proficient personal computer skills with MS Office (Word, Excel, Power Point, Outlook).

Nice To Haves

Master’s degree
Relevant Coding certification
Experience in staffing preferred.

Responsibilities

Direct the RCM operations functions to ensure all operations are consistent with Omega’s policies and procedures.
Identifies goals and initiatives to ensure efficient and effective operations for assigned clients. Analyze and ensure compliance with operational KPI metrics.
Develop the infrastructure, support framework to enable revenue growth, enhance profitability and/or productivity.
Identify, develop and implement best practices and procedures for internal and external operational improvements. Collaborate with senior/executive leadership to evaluate and adjust processes to improve operational efficiency and provide operational excellence.
Direct the overall audit and compliance requirements needed to comply with Federal, State and Local laws as well as client contract requirements
Serve as Liaison with Corporate concerning administrative matters in regard to client, consultant, and/or core employee matters.
Participate in formulating RCM market strategies and make recommendations on major business decisions.
Coordinate and ensure escalated issues are resolved.
Ensure employees are trained in new and existing systems and processes.
Develop annual budget requirements for operations teams.
Acts as Revenue Cycle subject matter expert for our clients and advises on best practices.
Revenue Cycle reporting and analysis of KPIs
Establishes adequate staffing levels based on revenue, account volume, account dollar value, ratio of accounts to employees, etc. to effectively manage production. As needed, adjusts staffing levels as necessary for expanded or changed services.
Ensure staff is trained effectively and efficiently to meet current and anticipated production goals. Oversee and direct management activity related to productivity reporting, QA audits, hiring, training, coaching, monitoring, appraising, disciplining, and terminating.
Leads monthly and quarterly meetings with client(s). Coordinates with internal client staff to create an agenda, assist in compiling and reviewing reports, ensure minutes are completed.
Continually assesses staff, workflows, and systems. Implements, proposes, streamlines and/or changes existing processes to improve overall client performance while maintaining profitability or creating a more cost-effective use of resources.
Ensure effective and timely communication occurs within and across the department through formal staff meetings, ad-hoc meetings, one-on-one feedback sessions, written materials or other informational medium.