Director, Revenue Cycle Management

OneOncology•Hickory, NC

About The Position

Carolina Oncology Specialists has been caring for patients in Catawba County since 1983, offering patients high quality, personalized healthcare close to their own home so patients and caregivers don’t have to travel far for excellent care. Our patients experience the convenience of in-clinic chemotherapy treatments, as well as the treatment and management of blood disorders. Why Join Us? We are looking for talented and highly-motivated individuals who demonstrate a natural desire to support the meaningful work of community oncologists and the patients we serve. Job Description: Responsibilities Build and manage a high performing team, including but not limited to; insurance verification, authorizations for treatments, upfront collections, financial counseling, coding and compliance including audits and education billing, cash posting, and AR management. Build relationships with external business partners and internal leadership. Leverage technology to optimize workflows that drive efficiency, quality, and accuracy. Create strategies to identify root cause billing and coding issues. Optimize workflows to address issues through process improvement. Assist in identifying, recommending, and implementing operational changes that will improve service, productivity, quality, and/or financial performance of the organization. Develops a culture that is customer centric and supportive of staff, fostering teamwork and high performance. Oversee hiring, training, personal development, retention, mentoring and position control. Direct supervision of staff including management and supervisory roles. Responsible for coaching and disciplinary issues within the department. Develop and maintain written departmental policies that are in compliance with all applicable coding rules, regulatory guidance and collection law. Oversee the compliance program which includes provider documentation, auditing, education, and HCC coding. Also includes auditing and education of the coding team. Develop KPIs and drive employee and management performance to meet those metrics on a monthly basis. Provide monthly report to the CEO. Working knowledge of Oncology and the key drivers of the industry. Meet with industry representatives to maintain knowledge of new products coming to market as well as reimbursement and regulatory changes. Knowledgeable of payer policies, coding requirements, and billing-related regulatory requirements directing the team in accordance with these policies. Monitor contracts ensuring payments do not fall below set margin thresholds. Maintain relationships with key payer groups to resolve escalated payment issues. Our team values the work components of every member to create a culture of people helping people and making a difference in our lives and those we serve.

Responsibilities

Build and manage a high performing team, including but not limited to; insurance verification, authorizations for treatments, upfront collections, financial counseling, coding and compliance including audits and education billing, cash posting, and AR management.
Build relationships with external business partners and internal leadership.
Leverage technology to optimize workflows that drive efficiency, quality, and accuracy.
Create strategies to identify root cause billing and coding issues.
Optimize workflows to address issues through process improvement.
Assist in identifying, recommending, and implementing operational changes that will improve service, productivity, quality, and/or financial performance of the organization.
Develops a culture that is customer centric and supportive of staff, fostering teamwork and high performance.
Oversee hiring, training, personal development, retention, mentoring and position control.
Direct supervision of staff including management and supervisory roles.
Responsible for coaching and disciplinary issues within the department.
Develop and maintain written departmental policies that are in compliance with all applicable coding rules, regulatory guidance and collection law.
Oversee the compliance program which includes provider documentation, auditing, education, and HCC coding. Also includes auditing and education of the coding team.
Develop KPIs and drive employee and management performance to meet those metrics on a monthly basis.
Provide monthly report to the CEO.
Working knowledge of Oncology and the key drivers of the industry.
Meet with industry representatives to maintain knowledge of new products coming to market as well as reimbursement and regulatory changes.
Knowledgeable of payer policies, coding requirements, and billing-related regulatory requirements directing the team in accordance with these policies.
Monitor contracts ensuring payments do not fall below set margin thresholds.
Maintain relationships with key payer groups to resolve escalated payment issues.