Revenue Cycle Director
About The Position
Direct and oversee overall policies, objectives, and initiatives of NYAP’s not-for-profit revenue cycle activities. This includes direct oversight of credentialing, precertification process, billing, charge entry, payment posting, accounts receivable, third-party relations, compliance, and overall financial analysis to ensure the revenue cycle is effectively utilized. The role involves developing revenue department goals, objectives, and tactical plans consistent with NYAP’s strategic plan and vision. The Director will oversee a team and serve as the primary contact for various billing entities, keeping abreast of payer rules and regulations. Support for clinical directors and managers is also a key aspect, ensuring data quality and providing analytical reporting and training. The position is responsible for various back-end account resolution tasks and overseeing the development and implementation of revenue cycle protocols and procedures. Additionally, the role involves standard HR functions such as planning, assigning work, interviewing, hiring, training, and resolving employee issues.
Requirements
- Bachelors degree in Economics, Finance, Business administration or its equivalent
- minimum 5 years related experience
- Experience using Microsoft excel, Microsoft word, SQL and PowerBi
- Experience using analytical tools which include SQL, Python, Tableau/PowerBi and/or advanced excel
- Electronic Health Record system experience
- Experience with Great plain accounting platform, Waystar clearing house, Global Pay software and advanced excel
Responsibilities
- Direct and oversee overall policies, objectives, and initiatives of NYAP’s not-for-profit revenue cycle activities.
- Direct oversight of credentialing, precertification process, billing, charge entry, payment posting, accounts receivable, third-party relations, compliance, and overall financial analysis.
- Develop revenue department goals, objectives, and tactical plans consistent with NYAP’s strategic plan and vision.
- Gather productivity, metrics, AR aging analysis and financial data from the electronic health system and provide meaningful management information to the CFO, leadership, and other personnel on a regular basis.
- Oversee team of Revenue Cycle Manager, Revenue Cycle Analyst and Revenue Cycle Specialists.
- Serve as the primary contact for outpatient mental health and foster care billing to sustain positive working relations with Medicaid, Managed Care Companies, Private Insurance, County Boards and Federal entities.
- Keep abreast with Medicaid and other third-party payer rules and regulations with respect to billing and communicate this information to the providers/clinicians and appropriate personnel.
- Keep updates on behavioral health practices such as HIPAA compliance, Medicaid audit requirements, Federal rate changes, Electronic Health Record system experience and ICD-10 coding changes.
- Support Clinical directors and Managers to ensure the quality of the insurance, demographics and eligibility data entered, as well as monitoring all time-of-service collections by providing revenue cycle analytical reporting and training materials.
- Responsible for timely payment and denial posting, timely processing of correspondence, handling incoming patient/client services calls timely, timely credit balance resolution, timely accounts receivable resolution and all other information pertaining to back-end account resolution/revenue cycle management.
- Oversee development, maintenance, implementation and training of protocols, policy and procedures for all functions related to the revenue cycle.
- Responsible for planning, assigning, and directing work, interviewing, and hiring employees, training employing, addressing complaints and resolving problems.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
