Director of Revenue Cycle

Company Overview:

They will also develop metrics and reporting that relate to authorization management, credentialing, contracting and the revenue cycle at Little Leaves, while ensuring compliance with all applicable regulations.

Responsibilities:

Essential Job Functions:

• Develop objectives and key results related to RCM functions
• Drive optimization and standardization of processes to meet or exceed objectives
• Utilize revenue cycle analytics platforms, including dashboards and reporting tools, to improve short-term outcomes and develop long-term goals
• Partner with organizational leadership to ensure appropriate staffing levels and optimal balance of workload
• Partner with cross-functional leadership and key stakeholders in analysis of claim denials, underpayments, compliance risks, client satisfaction, client financial counseling, and change management procedures
• Partner with Accounting to reconcile each month the practice management system and general ledger
• Ensure compliance with all applicable billing regulations, payer guidelines, third-party regulations, and Little Leaves standards
• Actively seek out and implement process improvement opportunities
• Develop and implement strategic plan to address accounts receivable aging, including utilizing industry benchmarks and other available resources to set and achieve goals
• Drive innovation in economic and clinical performance as it relates to revenue cycle
• Develop and implement internal audit processes and performance criteria for all revenue cycle roles to support reaching goals and metrics, using results to identify training opportunities
• Provide revenue cycle leadership representation on committees and special projects
• Develop and maintain revenue cycle written standards, standard operating procedures (SOPs), and other policies and practices to achieve high performance objectives (e.g. DSO, provision rate, denial rate, etc.)
• Facilitate a partnership between revenue cycle and other internal management teams that optimizes coverage and reimbursement for services rendered
• Consistently demonstrate a high level of integrity, responsibility, accountability, teamwork and ethics
• Follow all Company policies and procedures and serve as a model for others to follow such policies and procedures
• Performs other duties, as requested

Positions Supervised (Direct Reports):

• Billing & AR Team
• Authorization Team

Skills, Abilities, and Other Requirements:

• Experience in establishing internal controls across functions and quality controls within functions
• Experienced in health insurance contracts, authorizations and coding, i.e. CPT, HCPCS, ICD-10
• Excellent communication and presentation experience
• Experiences in accounting transactions, general ledger maintenance and reconciliations
• Understanding of HCFA 1500 insurance claims processing via electronic data interchange (EDI)
• Experience setting up and maintaining Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT)
• Understanding of insurance claim rejections and denials and appropriate resolutions
• Understanding of best practices in billing and collections
• Experience setup and maintenance of practice management systems
• Ability to identify issues in systems or processes and work with the team to resolve effectively
• Understanding of revenue cycle reporting and metrics
• Exercise confidentiality and discretion pertaining to the work environment
• Sensitive to working with an ethnically, linguistically, culturally, and economically diverse population
• Demonstrate high commitment to excellent customer service
• Demonstrate flexibility and ability to reprioritize
• Commitment to functioning as a team player
• Maintain required trainings
• Must clear DOJ/FBI background check and exclusion screening process, prior to and during employment

Qualifications:

Minimum Education or Training Equivalent to:

• Master’s degree from an accredited college or university in one of the following disciplines: accounting, healthcare management or business management, preferred
• Bachelor’s degree from an accredited college or university in one of the following disciplines: accounting, healthcare management or business management, required

Minimum Additional Related Experience:

• Ten or more years of experience in revenue cycle management or accounting/finance in the healthcare industry, preferred

Posted Min Pay Rate: USD $100,000.00/Yr.

Posted Max Pay Rate: USD $125,000.00/Yr.