Director Of Revenue Cycle

GENERAL SUMMARY OF DUTIES: Monitor performance of our 3rd party billing company to ensure collections are meeting expectations. Work with doctors to clarify the revenue cycle process and answer any questions they may have. The primary duties of this individual will be to analyze and identify issues within reports, proactively communicate with providers, and work with our billing company to improve collections as well as work with the onboarding team to ensure payer enrollment is done timely and for the appropriate payers. Also, will be a part of the team to help transition newly acquired groups to our billing system and monitor and work out any old AR if necessary. Work with the operations team to communicate to the providers on expectations.

DUTIES INCLUDE BUT ARE NOT LIMITED TO:

• Learn/understand how providers in general are paid as this drives conversations
• Work with analyst to develop denial reporting and keep eye on trends
• Monitor denials and rejections to understand the root cause and correct on the front end
• Work with credentialing to understand areas of improvement in process and payers that need to be enrolled
• Deep understanding of revenue cycle and the related nuances ; payer and state specific rules, physiatry/internal medicine, SNFs, coding, rule changes, CMS changes, patient collections, charge capture, and denial reasons
• Assists in the identification of areas of concern and develops a recommended course of action
• Nice to have would be ability to read contracts and the process of negotiating with payers
• Work with business development team to answer questions regarding expected reimbursement
• Work with our analyst to build meaningful reports
• Proactively analyze individual providers to identify areas of improvement
• Comfortable with communicating with leadership and doctors through email and video chat
• Assist in onboarding newly acquired groups to our outsourced revenue cycle vendor
• Avoid the attitude of “that’s not my job” as there will be opportunities to grow and learn new skills as we continue to grow larger and larger each year
• Provide recommendations to strategically enhance revenue cycle performance
• Pull raw data and decipher the cause of the collection issue; is it timing, credentialing, denials, etc.
• Keep a close eye on recently onboarded providers to be sure claims are being billed and collections are not delayed
• Work with analyst to run reports, analyze data, and communicate to providers specific information regarding their charges and collections.
• Learn and understand business of physiatry and internal medicine in the SNF, ARF, and hospital settings
• Eager to learn new systems and processes and to have the willingness to work with all colleagues across all departments.

KNOWLEDGE, SKILLS & ABILITIES –

This position requires the following minimum requirements:

• Skilled in analyzing trends.
• Communicating effectively with others in writing as indicated by the needs of the audience.
• Skilled in analyzing/interpreting complex data/reports
• Very knowledgeable of the revenue cycle process
• Very limited travel, 2-3 times a year
• Nice to have background using Tableau or similar reporting software
• Skill in planning, organizing and supervising multiple assignments concurrently.
• Ability to work independently and remotely
• Proficient in Microsoft, specifically Excel
• Skill in exercising initiative, judgment, problem solving and decision-making.
• Knowledge of organization policies, procedures, systems and objectives.
• Skill in developing and maintaining effective relationships with finance, operations, and business development

EDUCATION: Bachelor’s Degree in Business Administration or other Related Area

EXPERIENCE:

• At least 5 years in similar revenue cycle environment

• • Prefer knowledge of SNFs and complex rev cycle situations