Director Revenue Cycle Management

Cleveland Clinic-posted 25 days ago

Full-time • Director

Remote • Cleveland, OH

5,001-10,000 employees

Ambulatory Health Care Services

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Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will receive endless support and appreciation and build a rewarding career with one of the most respected healthcare organizations in the world. The Director of Revenue Cycle Management provides direct supervision to Revenue Cycle managers and supervisors overseeing the organization's professional accounts receivable. Responsibilities include monitoring integrated Revenue Cycle activities such as billing and no-response follow-up. This leader is also responsible for establishing and implementing policies and procedures and for developing and maintaining effective controls over all back-end Revenue Cycle functions. A caregiver works remotely from 8:00 a.m. - 5:00 p.m. A caregiver who excels in this role will:

Develop departmental goals, plans and standards consistent with the clinical, administrative, legal and ethical requirements/objectives of the organization.
Plan, organize and direct all activities related to staffing, including hiring, orienting, evaluating, disciplinary actions and continuing education initiatives.
Prepare departmental budgets and ensure that the department operates in compliance with allocated funding.
Coordinate and direct internal/external audits.
Serve as the primary liaison for resolving issues and escalations, coordinating between internal teams and external stakeholders to ensure timely and accurate billing.
Knowledgeable of all billing and follow-up regulations for each of the respective payers. Knowledge level should be such as to allow the Director to educate departmental personnel of regulations and allow the Director to understand the financial impact of regulatory changes.
Monitor denial trends, drive mitigation efforts, resolve issues and support cash flow by overseeing collections across assigned work groups.
Oversee daily billing operations and collections to drive timely reimbursement.
Demonstrate broad knowledge of applicable statutory, regulatory and administrative requirements relative to departmental operations and ensure compliance with the same.
Responsible for continuously monitoring the effectiveness of policies and procedures, ensuring that billing is in compliance with all federal, state, and other regulatory requirements.
Make recommendations to Administration relating to improving functions of Revenue Cycle.
Responsible for determining when appropriate to develop and implement new policies and/or procedures as appropriate.
Collaborate with third-party payors, medical staff, administrative staff, department managers, community leaders and other to assist with meeting operational needs of Revenue Cycle Management.

Bachelor's degree and seven years of experience in a large clinic/group practice or hospital patient accounting operations
OR Associate's degree and nine years of experience
OR High School diploma/GED and 11 years of experience
Extensive experience in insurance receivables, including both billing and follow-up to ensure timely reimbursement
Certifications/licenses may be required by specific departments
Ability to communicate and exchange accurate information.
Ability to perform work in a stationary position for extended periods.
Ability to work with physical records or operate a computer or other office equipment.
In some locations, ability to travel throughout the hospital system.
In some locations ability to move up to 25 lbs.
Follows standard precautions using personal protective equipment as required.

Vendor relationship experience
Strong RCM Back End experience (Physician or Hospital Billing Experience)
Strong knowledge of EPIC
Successfully managed large remote teams

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