Director Revenue Cycle

Job Description:

Job Summary:

The Director Revenue Cycle is responsible for directing network wide revenue cycle management ad all related process improvement initiatives to maximize the financial performance and integrity of health center activity. Oversees all revenue cycle activities including internal provider credentialing/ privileging, provider insurance credentialing/revalidations, facility insurance credentialing/revalidations, practice management system set up/maintenance, claim creation/processing, vendor management, portal management, accounts receivable follow- up patient collections/refunds, payment/billing compliance, and revenue cycle training. Directs and leads staff within the scope of revenue cycle management. Ensures department activities and outcomes are aligned with the strategic plan and the organizations mission, vision, and values. Facilitates process improvement to affect change to achieve revenue cycle best practices. Ensures consistency and compliance throughout the network

Essential Functions:

* Manage all departmental matters including personnel, resource management, reporting, training, and other organizational requirements

* Develop training plans, facilitate staff training on policies/ procedures, HER software, other relevant software, systems, metrics, compliance related to the revenue cycle process

* Creates work standards, monitors quality and quantity of work processed, and ensures that policies are communicated and administrated consistently

* Management of all business-related functions of the patient visit from point of charge posting, billing, payment posting, deposits, and accurate adjunction of the patient’s accounts. Ensures all services performed are billed/collected for

Analyzes, troubleshoots, and measures performance for the processes affecting the revenue cycle

* Implement reliable solutions for improvement; continually identifying opportunities to automate processes and maximize collections

* Works in partnership with the Health Systems Administrators to ensure optimal system configuration is maintained

* Determines opportunities for improvement

* Ensures patient credit balances are handled promptly and appropriately

* Acts as the liaison between the health center and health insurance plans, practice management systems, and third-party vendors * Oversees the Credentialing Manager and ensures all billable providers are appropriately privileged internally and credentialed through contracted health plans

* Oversees the patient financial Counselor and all applicable workflows, i.e., Compass Portal administration, Sliding Fee Discount Program compliance, patient balance review, etc.

* Collaborates with all levels of the organization to drive results in the above areas. Makes strategic recommendations to improve workflow

* Builds and runs reporting out of the electronic health records o facilitate collections and to build workflow with other departments * Reports all revenue cycle activities to executive management for strategic goal building and financial sustainability

Supervisory Functions:

* Revenue Cycle Manager * Credentialing Manager * Patient Financial Counselor * Lead Revenue Cycle Specialist * Population Health Specialist

Competencies:

* Technical Skills

* Supervising Others

* Delegation

* Problem Solving

Decision Making

* Process Orientated

* Project Management

* Reporting and Analysis

* Data Visualization

* Detail Oriented

* Team Building

* Billing and Insurance Knowledge

* Communication- Verbal