Revenue Cycle Director

About the Role

Manages all business-related functions of the revenue cycle, from client point-of-entry to accurate adjudication of client accounts. This includes charge processing, claim submission and processing, payment processing, collections and receivables management, denial management, reporting, analytics, auditing, customer service, training, and all other revenue cycle management activities.

Responsibilities

• Manages a team of A/R reps, billers, verification specialists, and cash posters, including hiring, training, evaluating, and developing staff; conducting annual performance evaluations; and holding regular meetings to communicate procedures, processes, and effectiveness.
• Provides regular revenue-cycle status reports, including metrics and presentations, to upper management.
• Develops, monitors, and assesses business metrics to refine processes and improve performance, collaborating with other departments to implement changes and improve revenue workflow.
• Analyzes and corrects root causes of denials, billing errors, database errors, and other issues resulting in non-payment or denied claims.
• Monitors clearinghouse performance and manages Fee for Service grant billing to ensure timely and accurate billing.
• Establishes relationships with key personnel at payer organizations and resolves escalated reimbursement issues with payers.
• Monitors billing regulations and payer requirements for changes; coordinates implementation of updates.
• Reviews and reconciles A/R and allowance general ledger balance sheet accounts; monitors adequacy of allowance account methodology.
• Manages and monitors billed vs. approved rates.
• Develops, implements, and maintains revenue-cycle standard operating procedures.
• Follows all organizational policies and procedures and completes mandatory training within prescribed timeframes.

Requirements

• Bachelor’s Degree in accounting or business (required); MBA (preferred).
• More than 8 years of revenue-cycle experience in a complex healthcare environment, preferably within behavioral health or health and human services, including 3–4 years of supervisory or management experience.
• Proven grant management, billing, and accounting knowledge.
• Experience with management reporting and analysis.
• Proven experience building teams and driving process improvement initiatives.
• Excellent internal and external customer service skills.
• Strong process and quality orientation.
• Excellent oral and written communication skills; ability to recognize the importance of teamwork.
• Proficiency in Microsoft Office with advanced Excel skills.

Schedule

Full time