Director of Revenue Cycle Management

Health Solutions is a premier wellness center focused on whole-person care. With over 400 employees in Southern Colorado, you would be joining a mighty team of support and administrative staff, case managers, clinicians, physicians, nurses, and others in our efforts to improve the health and wellbeing of our community.

We’re expanding and looking for a Director of Revenue Cycle Management to join our finance team at 41 Montebello Road, Pueblo, CO.

What You Would Be Doing

The Director of Revenue Cycle Management (DRCM) is a challenging role in a growing organization. The ideal candidate must be able to roll up their sleeves to solve problems while responding and adapting to changing requirements from payers due to new regulations and new program additions. Candidates must have extensive experience working with Medicare, Colorado Medicaid and third party payers, strong leadership and excellent communication skills.

The DRCM reports to the Vice President of Finance and will supervise the billing team which includes three billers, one coder and one patient financial services supervisor. This position will be responsible for developing, monitoring, and assessing revenue metrics to refine processes, improve performance, and meet departmental KPI’s. The DRCM will also work closely with the electronic health record team, leadership and program managers to develop and implement systems, training, and internal controls to ensure billing systems and processes comply with state and federal regulations.

Additional responsibilities include:

• Regularly provide leadership with revenue/payment data, reports, metrics, and presentations.
• Oversees maintenance, updates of the relevant modules, set-up, and data tables in the electronic health record systems and related billing engines.
• Collaborates with the scrum team to ensure billing functions are being maintained or added as necessary in the electronic health record systems.
• Directs resolution of billing and payment issues and ensures proper communication to executive and program leadership in accordance with established parameters.
• Ensures analysis and correction of root causes of denials, billing errors, database errors, etc. that result in non-payment or denied claims.
• Collaborates with other departments/programs to design systems, train staff, monitor and implement changes needed to ensure effective and timely revenue workflow.
• Resolves escalated reimbursement issues with payers.
• Performs other duties as assigned.

What You’ll Like About Us

• Competitive pay. Base pay of $91,500 annually
• Generous benefits package. For most positions, includes paid holidays, generous PTO, Subsidized YMCA membership, tuition reimbursement, and FSA
  • Insurance: Medical, Dental, and Vision, with low deductibles. Also, Wellness benefits program available.
  • Retirement 403(b) with employer match up to 6%
  • EAP, Teladoc, LifeLock, Direct Path, Life and AD&D
  • Additional Insurance: FSA, Voluntary Life, Allstate Voluntary benefits, and pet insurance
  • Childcare
  • Flexible schedule
• Employee recognitions and celebrations
• Warm and friendly work environment in which staff respect and learn from one another
• Opportunities to serve our neighbors in Pueblo

What We’re Looking For—The Must-Haves

• At least 10 years of relevant supervisory experience and experience creating processes, policies and procedures in RCM
• Thorough understanding of billing processes
• Practical knowledge of payer-specific rules and regulations, including Medicaid and Medicare
• Excellent interpersonal and customer service skills
• Demonstrated experience to include counseling, analysis, collaborative teamwork, professional communications and interactions, advocacy, financial management, and customer service
• Willingness to work collaboratively with multiple teams and tasks
• Proficient in Windows-based computer programs and electronic charts, as well as basic office equipment
• Ability to multi-task and prioritize in a fast-paced setting
• Well-organized, self-motivated, and proficient time management
• Strong communication skills both verbally and in writing

What We’d Like to See in You—The Nice-to-Haves

• Experience working in Netsmart’s MyAvatar and NextGen electronic health record systems
• Spanish language skills

Health Solutions expects all staff to

• Adapt to change in the workplace and use change as an opportunity for innovation and creativity;
• Take ownership of problems, brainstorm problem resolutions, and use sound judgment in selecting solutions to problems, and demonstrate consistent follow through;
• Possess the job knowledge and skills to perform the fundamental job functions, and assume greater responsibility over time regarding the scope of work;
• Inspire and model collaborative teamwork; and
• Demonstrate accommodation, politeness, helpfulness, trust building, appropriate boundaries, and flexibility in customer service.

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  Notice: Health Solutions is an equal opportunity employer committed to providing a work environment that is free of unlawful harassment, discrimination, and retaliation. For more information visit: https://www.health.solutions/careers/

Closing Date: 4/15/2024 EOE, M/F