Revenue Cycle Director directs and oversees the overall policies, objectives, and initiatives of an organization's revenue cycle activities to optimize the patient financial interaction along the care continuum. Reviews, designs, and implements processes surrounding admissions, pricing, billing, third party payer relationships, compliance, collections, and other financial analyses to ensure that clinical revenue cycle is effective and properly utilized. Being a Revenue Cycle Director tracks numerous metrics related to the patient engagement cycle including record coding error rates and billing turnaround times to develop sound revenue cycle analysis and reporting. Manages relations with payers and providers to generate high reimbursement rates and a low level of denials. Additionally, Revenue Cycle Director requires a bachelor's degree. Typically reports to top management. The Revenue Cycle Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. To be a Revenue Cycle Director typically requires 5+ years of managerial experience. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. (Copyright 2024 Salary.com)
Description
Location: SGMC Patient Financial Services
Department: REVENUE CYCLE MEDICAL GROUP
Schedule: Full Time, 8 HR Day Shift, 8-5
POSITION SUMMARY
Reviews billed charges professional services to ensure quality and integrity are met according to compliance and official coding guidelines. Meets with management to report any discrepancies and provide education to providers in order to improve coding practices. Monitors coders accuracy and provide education to coders when needed. Effectively communicates with providers to clarify documentation issues and/or discrepancies. Interact with other team members of the revenue cycle and provider clinics. Tracks coding issues and reviews coding inaccuracies to include insurance denials to highlight areas of improvement. Responsible for education for newly hired physicians/providers to include re-education when necessary. Must be able to research LCD, NCDs along with the ability to provide proof of medical necessity. Maintains professional knowledge by attending educational workshops, webinars and other related educational sources. Serves as a subject matter expert in coding and coding related inquires for documentation, denials and billing. Must have highly effective and professional written and verbal communication skills. Knowledge of legal, regulatory and policy compliance issues regarding medical coding, billing, and documentation. Must be able to meet competing deadlines, be highly organized, goal driven, and work well with others. Assists in monitoring and reviewing of denials for education opportunities for Providers, clinic staff, and billing staff. Performs all other duties assigned.
KNOWLEDGE, SKILLS & ABILITIES
WORKING CONDITIONS - ADA INFORMATION
May spend long hours working at computer terminal. Must be able to see and read names, numbers, and colors. Subject to high stress levels.
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