Enterprise Director, Revenue Cycle Management

PRIMARY FUNCTION

The Enterprise Director is responsible for overseeing all aspects of Revenue Cycle Management across all regions (East, Central, and West). This role provides leadership, development and training, and operational goals to ensure all Billing, Coding, and Revenue Management functions are aligned and optimized to meet or exceed expectations.

ESSENTIAL DUTIES AND RESPONSIBILITIES

This list may not include all of the duties that may be assigned.

1. Establish benchmarks and performance metrics for revenue cycle management operations to ensure the appropriate optimization of revenue and collections throughout billing functions.
2. Provides guidance and oversight by developing practical, system-oriented revenue cycle strategies and initiatives to drive significant performance improvement value to our organization
3. Develop, evaluate, implement and maintain policies and procedures to ensure quality with billing practices and maximize reimbursement of physician services while complying with all applicable government and other regulatory agencies.
4. Leads Process Improvement, Policy Development, and Best Practices for the RCM function to include streamline billing and collection processes across all billing platforms
5. Establish project plans to ensure the achievement of the company's financial targets across functional departments to exceed revenue projection, optimize reimbursement, reduce days in accounts receivable, and denials.
6. Responsible for management of department budgeting and forecasting, goals, and initiatives.
7. Maintains effective communication with third party insurance carriers for resolution of underpaid and/or unpaid claims of one or more specialties related to the third party, government and/or patient billing for professional healthcare services.
8. Monitors reimbursement patterns of contracted and non-contracted carriers, including government agencies, and resolves issues. Escalates potential risk or critical issues to Department leadership.
9. Leads all functions of management for the team including selection, oversight the onboarding and training program for new staff. Evaluates performance, provides feedback, and motivates staff to reach departmental established objectives.
10. Create and/or review weekly, monthly, and quarterly reports and presents monthly to SVP of RCM.
11. Lead special projects and reports to ensure maximum payments.
12. Perform other duties as assigned.

SUPERVISORY RESPONSIBILITIES

Oversee RCM for all Regions, Directors, and Managers

Staff - 100+

QUALIFICATIONS

EDUCATION: Minimum of Bachelor's Degree with a focus in Health Information Management or Healthcare Administration required.

Minimum of related 5 years' experience is commensurate to the education required

EXPERIENCE: Minimum of 6 years directly related to RCM in health care setting required.

A minimum of 5 years in a supervisor or management capacity required.

KNOWLEDGE, SKILLS AND ABILITIES

• Proficient working with Microsoft Office including Word and PowerPoint
• Strong/Advanced MS Excel skillset and ability to run analytics
• Knowledge of medical coding and documentation education training and development preferred
• Advanced Outlook skills
• Ability to provide written and verbal presentation
• Strong analytic and problem-solving abilities
• Excellent verbal and written communication skills
• Excellent interpersonal skills with the ability to engage at all levels of the organization
• Ability to efficiently multi-task, plan and prioritize a large volume of detail-oriented work in accordance with changing deadlines, ability to communicate goals clearly and compassionately
• Accelerated knowledge and expertise in front office operations, managed care, and health care settings; current knowledge of best practices in practice management and operations.
• Knowledge of billing and collection policies and procedures, all types of insurance (HMO, PPO, POS, Medicaid etc.)
• Skill in defining problems, collection of data, interpreting billing information.
• Strong leadership and communication skills both written and verbal.
• Ability to work effectively both individually and as a team
• Ability to be creative, innovative and resourceful
• Ability to assess, use good judgement, expertise and analytics to make sound decisions
• Possess applicable knowledge of regulations impacting AR
• Maintains a current working knowledge of CPT/ICD-9 coding regulations as set forth by all related government and regulatory agencies

TYPICAL WORKING CONDITIONS

• Non-patient facing
• May be either full time remote/telework or rotate working in the office and remote/telework
• If remote, this job must be U.S. based
• Indoor work; professional office environment
• Operating computer
• Reach outward
• May require sitting or standing for long periods, including stooping, bending, stretching
• Requires occasional lifting of files and boxes weighing up to 25 lbs
• Manual Dexterity

OTHER PHYSICAL REQUIREMENTS

• Vision
• Sense of sound
• Sense of touch