12/10/2024
Bill Greenberg is hiring, please reach out to him at [email protected] if you are interested.
Director of Revenue Cycle Management-VP US Operations
The Director of Revenue Cycle Management-VP US Operations is accountable and responsible for the overall leadership of revenue cycle services of the faculty practice group in both provider-based and hospital office settings.
Position Summary:
This role requires current, in-depth knowledge of governmental and commercial insurance rules and regulations, including regulatory compliance requirements applicable to a physician group revenue cycle that has both provider-based and physician office site of service components. The Director of RCM is accountable for ensuring the coordination of revenue cycle operations, procedures, and best practices for provider insurance credentialing, charge capture, billing, payment posting, collections and follow up, denials management, billing audits, and revenue cycle data reporting throughout the organization.
Daily Activities & Continuous Improvement:
• Evaluating the effectiveness of centralized revenue cycle services, including charge capture, billing, collections, data reporting, and implementing changes to policies, procedures and systems, as appropriate.
• Providing the analysis, reporting, recommendations and implementing strategic action plans for revenue cycle services performance in key metrics related to charge capture, billing, collections and accounts receivable management, such as volumes, collection ratios, A/R aging, charge lag, and related trends to the CFO and practice management staff.
• Setting budgetary guidelines and making spending and resource decisions within those guidelines, ensuring accountability to operating and capital budget.
• Creating a department wide understanding of the regulatory issues affecting Revenue Cycle, provider documentation and coding and maintaining compliant policies and procedures.
• Assesses and responds to current and future internal and external healthcare trends to establish and ensure the necessary direction for revenue cycle activities.
• Continually seeks ways and means for improving the delivery and support of revenue cycle activities and programs including monitoring the routine development of training material and ensuring educational resources to current and future staff.
• Assures satisfaction among administration and providers with the quality and amount of support and data provided by monitoring and responding appropriately to outcomes and feedback while fostering a positive patient experience.
• Understands the job functions of all Revenue Cycle staff, is aware of process flow across departments, and involves them, as appropriate, when recommended actions may impact their work functions.
• Demonstrates good judgment in making decisions (timing, involvement of others, information presented, impact on others and operations) and is resolute in making a decision to act.
• Leads efforts in monitoring and researching of regulatory changes and proposes actions to respond to changing legislation/regulations.
• Directs the maintenance of the practice management system master files for ensuring that the system is capable of efficiently managing the billing process.
• Monitors the payments of third-party payers for assessing compliance with established contracts.
• Develops policies and procedures for all point of the revenue cycle including, but not limited to, charge capture, data entry, payment posting, insurance follow up, collections and denials management.
• Reviews and updates the charge master, adjustment and denial codes as necessary. Identifies trends and accordingly makes appropriate recommendations.
• Holds regular meetings with departmental supervisors and keeps them abreast of important issues related to revenue cycle operations.
• Develops and maintains relationships with major payers.
• Acts as a liaison for dealing with departmental supervisors and hospital staff.
• Develops and implements evaluation tools and measures staff efficiency and effectiveness.
• Researches department, payer, provider and other specific issues associated with revenue cycle performance.
• Works with staff from Information Systems to ensure system integrity.
• Keeps abreast of industry regulations, standards, trends and technologies.
• Troubleshoots problems associated with missed or unbilled charges, payment delays, denials, and other revenue cycle issues.
• Other duties assigned.
Knowledge, Skills and Abilities:
• A bachelor’s degree in business, health care administration or related field is required; Masters preferred in a related field.
• Excellent communication and collaboration skills across a range of stakeholders.
• Minimum 10 years of revenue cycle experience with progressive responsibility managing hospital and physician group revenue cycle functions.
• Experience with practice management systems such as Athena, Epic, etc.
• Knowledge of Managed Care, Third Party Payer, and Medicare Regulations.
• Prior experience leading various areas of revenue cycle (charge capture, coding, billing, collections, denials, etc.) with proven success in achieving revenue cycle efficiencies and improving cash flow.
• Experience with data analysis in the healthcare industry.
• Experience working closely and communicating directly with physicians, and executives.
• Must have the ability to handle multiple tasks and work with various tight deadlines.
• Strong communication skills.
• Demonstrated interpersonal skills to work with physicians, patients, and staff at all levels, must have the ability to relate to people in a manner to win confidence and establish rapport.
• Requires 1- or 2-days’ monthly US overnight travel to client locations
• Requires the ability to travel overseas to India and the Philippines once or twice a year for a two-week period.
• OFFSHORE EXPERIENCE A BIG PLUS
• FULLY REMOTE WORK FROM HOME POSITION
ABOUT THE COMPANY:
Company is a full -service healthcare solutions firm focused on maximizing return on investment, increasing revenues and improving productivity for our valued clients.
We do this by providing low-cost, offshore business solutions for U.S. healthcare providers and billing companies.
Our philosophy is founded on service, training and transparency.
We strive to deliver personalized, flexible solutions based on each of our clients' unique needs.
We achieve this by investing in our employees training and ongoing career development.
This allows us to boast and maintain a 98% coding accuracy rate.
Back in the U.S., clients have direct access to a productivity dashboard. This homegrown technology provides our partners with instant access to their project's status at the click of a button. Most importantly, you'll never have to worry about the security of your data.
We are HIPAA and SOC2 compliant, always putting the integrity of your information first.
