Revenue Cycle Management, Director

Revenue Cycle Management, Director

The Director, Revenue Cycle Management is a pivotal role at Thirty Madison. This individual will lead our growing payor contracting, revenue cycle management, and prior authorization teams, and help set our strategy for continued growth.  As the Director, Revenue Cycle Management, you will be responsible for leading the complete revenue cycle activities and performance for KMG Medical Group, including responsibility for patient accounts, billing, collections, coding, credentialing, contract management, outsourcing, vendor relations, patient access, centralized services, customer service, compliance, and physician satisfaction. You will also work closely with our Clinical team to streamline our prior authorization processes, and our Commercial teams to support on-going FFS contracting activity.

You are a great fit for the role because you have a deep understanding of insurance operations and regulations, are relentlessly analytical, a creative and versatile problem solver and thrive in a fast-paced, constantly changing environment. The operational leadership qualities you possess will be vital while guiding our team members as we disrupt the healthcare industry. Above all, you embody Thirty Madison’s mission to serve more patients and give people access to the healthcare they need. 

This role reports to our Senior Director, MSO. It is a remote role, with travel expected to our corporate office in NY.

Comp | Perks | Benefits 

• Competitive salary packages (base, bonus and equity option packages)
• 100% coverage on many health, dental, and vision insurance plans
• 401k with a match, commuter benefits, and FSA
• Annual $750 vacation stipend and $750 wellness allowance

What you get to do every day

• Create and implement the strategy for a scalable revenue cycle management organization for Thirty Madison’s medical and pharmacy billing needs
• Responsible for planning, coordinating, and executing policies, procedures, and strategies to ensure timely and efficient billing and collection and to minimize claim denials for healthcare programs
• Accountable for ensuring we hit SLAs across the revenue cycle, including collection rates and denial rates and for promptly addressing concerns
• Ensure that cross-departmental operations are optimized and aligned with other operations within healthcare revenue cycle 
• Help establish and act as the primary operating officer for billing, collection and cash application, managing day to day operations
• Work closely with physician leadership to maintain accountability and best practices healthcare information management
• Participate in setting the strategic direction of the healthcare revenue cycle and identify areas of continuous improvement in conjunction with the Finance team
• Establish, continuously evaluate and improve workflows within the billing and collections department
• Work to improve data integrity and clinical documentation as it affects billing and collection
• Assist in strategy development across functional departments to meet or exceed TM revenue projections, reduce days in accounts receivable, and properly address and ultimately limit denials and write-offs
• Ensure compliance with state and federal law, HIPAA and other regulatory guidelines
• Identify technologies to enhance healthcare revenue cycle operations and be the primary business champion for technology implementations within the cycle
• Develop strategies to reduce the overall cost to bill and collect healthcare revenue
• Work with the MSO team and clinical leadership to maintain and improve the quality of health information management
• Keep track of the changing payor regulatory landscape and how it might affect KMG’s telehealth model

What you bring to the role

• Bachelor’s Degree in Accounting, Business or related field or equivalent related experience is required.
• 8+ years of high-performance leadership in fast-paced and complex organizations
• Extensive experience standing up and managing revenue cycle management teams. Prior Authorization experience a plus
• Demonstrated experience building and scaling operational processes and teams for multi-specialty medical groups
• Strong project management skills with the ability to manage multiple projects and the desire to bring structure to undefined procedures
• Interest and passion for changing the landscape of healthcare
• Expertise in innovating both the clinical and business sides of pharmacy and care delivery  
• Proactive, inquisitive, positive, collaborative and comfortable working in ambiguity 
• Dedication to leading and developing teams 
• Passion for building an inclusive culture and contributing to the overall Thirty Madison mission and values