Director, Revenue Cycle Management

DescriptionJob Summary:Responsible for overseeing and coordinating revenue cycle activities with a goal ofmaximizing reimbursement in cost effective manner that is in compliance with federal,state, and payor-specific billing requirements. Revenue cycle activities include payorcontracting, negotiation, registration, credentialing, coding, charge capture, chargeentry, billing, collecting, payment entry, and reimbursement analysis. The RevenueCycle Manager is also responsible for supervising and developing the AccountsReceivable Billing Manager. Finally, this position will be responsible for establishingproductivity standards/goals and monitoring performance against these.Essential Functions:Develops, implements, and maintains CMG revenue cycle standard operatingprocedures.Ensure patient eligibility is checked and benefits are verified in accordance withpayor contracts and as necessary to minimize accounts receivable exposure.Ensures authorizations are obtained for required servicesEnsures cash posting is timely and accurateEnsures timely and accurate billing of claims to payors. Ensures patient financial concerns are addressed, including but not limited toinsurance coverage and refunds.Monitors accounts receivable aging and ensure appropriate collection proceduresare being followed.Establishes internal collection goal(s) and regularly compares to identified externalbenchmark(s).Resolves escalated reimbursement issues with payors. Participates in/project manage special projects as requested/required. Participates in the review of payor contracting including credentialing, and on-goingcontract compliance.Supervisory Responsibilities:Provides leadership and guidance to the Accounts Receivable Billing Manager, PatientRegistration Supervisors, Patient Access Supervisor, Manger Cash Applications, andManager NPFC in the conduct of their job. Accurately assesses each strengths anddevelopment needs and provides timely feedback and coaching.Essential Qualifications:Education/Certification: Bachelor’s degree or equivalent in business orrelated field requiredRequired Knowledge: Proficiency in Microsoft Excel. Strong knowledgeof medical billing, including ICD-10. Knowledge ofbehavior health billing.Experience Required: Minimum 8 years of revenue cycle experience withat least 5 years being in a healthcare environment.At least four years medical revenue cyclemanagement experience required. Experiencewith behavioral health billing preferred.Skill and Ability: Ability to work collaboratively with colleagues.Strong organizational skills with a keen ability to prioritize andmulti-task.Ability to adhere to and meet deadlines.Good communicator (oral and written).Strong administrative and data management skills.Ability to raise issues proactively and in a timely manner.Job Or State RequirementsBachelor’s degree or equivalent in business or related field required. Minimum 8 years of revenue cycle experience with at least 5 years being in a healthcare environment. At least four years medical revenue cycle management experience required. Experience with behavioral health billing preferred.