Director, Revenue Cycle

Job Responsibility

Leads a Revenue Cycle group by communicating with and developing staff members, and building consensus for programs and goals that support a business, function or geographic area.

Develops and articulates a short-term strategic vision for areas of responsibility.

Ensures Revenue Cycle meets all financial goals through efficient and effective operations; consistently reviews On-Site operations and Business Office productivity/ production goals and objectives; conducts planned and unscheduled visits to review On-Site operations and Business Office operational efficiency; meets regularly with management to discuss successes, issues, reoccurring problems, and action plans to improve/address them.

Arranges for periodic management team meetings to discuss problems/ issues with hardware, facility space and general working conditions; reviews monthly and annual status reports addressing key performance indicators, as well as plans for next period; monitors Revenue Cycle's overall financial performance on a monthly basis; keeps abreast of all federal, state and third-party payer rules and regulations; apprises staff.

Develops and implements annual business plan to maximize Revenue Cycle's revenues; involves On-Site operations and management team in developing annual business plan; closely monitors Revenue Cycle's progress during implementation of business plan; collaborates with management to modify business plan to maximize revenues.

Schedules overtime to meet projected revenue goals, when necessary; selects, develops, manages, and evaluates direct reports; oversees the selection, development, management and evaluation of indirect reports; identifies and evaluates opportunities to increase clinical practice volume; assists physicians with program implementation to achieve volume and revenue goals.

Recognizes program expansion opportunities.

Consistently assists physicians with questions concerning the financial components of their practices; monitors program implementations to ensure that they are achieving expected volume and revenue goals; develops and maintains cooperative quality relationships with physicians; consistently works with physicians to achieve Revenue Cycle goals and objectives.

Arranges for new physicians to learn about Revenue Cycle's requirements for billing and collections; collaborates with management and physicians to resolve issues/problems in a timely manner and prevent their recurrence; prepares Revenue Cycle annual budget and manages operations within established budget; completes annual budget with designated time frame.

Involves On-Site operations and Business Office management team in development of annual budget; holds quarterly budget meetings with management to review Revenue Cycle progress in making budget; notifies organization the leadership on a timely basis of budget variances; plans to reduce/eliminate variance; represents Revenue Cycle in industry and professional associations.

Arranges for important payer newsletters/memoranda to be copied and forwarded for management review and response; presents positive image of organization Revenue Cycle to outside organizations; maintains billing and collection practices consistent with all payer guidelines and reimbursement rules and regulations.

Guides management in responding to changes in payer guidelines and reimbursement rules and regulations; contacts third-party carries on issues requiring top management's involvement; works with Revenue Cycle staff and management in reacting to changes in the provider community and organizing coalitions to jointly approach third-parties in a unified manner on issues adversely affecting Revenue Cycle.

Job Qualification

• Bachelor's Degree required, or equivalent combination of education and related experience.
• 8-12 years of relevant experience and 7+ years of leadership / management experience, required.
• Preferred Qualifications:
• 5+ years of direct experience leading a Denials Management, Appeals, or Underpayment Recovery team
• Strong knowledge of Medicare and Medicaid programs
• Strong Epic System proficiency