Revenue Cycle Director Jobs

• Identify payment issues, potential fraud items, research out of balance issues and perform necessary GL and Member account adjustments.
• Serves as key participant in system and process improvement projects that are sponsored by the Department.
• Plans, organizes, directs, and coordinates financial revenue cycle operation of the Department, including financial planning, budgeting, billing, and accounting functions.
• Provides ongoing analysis as needed to members of the upper management team.
• Assists in the preparation of monthly management reports providing key revenue and operational metrics and analysis to executive managers. Assists with cash management projections and forecasting activities. Assists in optimizing financial systems and processes resulting in more efficient financial processes and controls to ensure the highest level of data integrity and accuracy.
• Assess explanation of benefits (EOBs) from insurance companies.
• Develops revenue cycle projections of Department clinical income and expenses, assists with preparing yearly budgets for Department and provides regular financial reports regarding Department's clinical financial status.
• Keep accurate billing records and report any discrepancies to accounting.
• Conduct audits for billing cycles.
• Prepare payment batches.
• Accept payments and process billing statements.
• Reviews revenue calculations for accuracy and completeness. Reviews the Department's account reconciliations and other supporting information submitted to ensure compliance and accuracy.
• Performs other job-related duties as assigned.
• Provides ongoing revenue accounting oversight to the Department and the Finance and Accounting arm of the Medical Center and Clinics.
• Oversees establishment of Department accounting procedures as it relates to the clinical practice revenue cycle.
• Manages Revenue Cycle Management team operations including all aspects of coding, charge-entry, claims submission, collections and payment posting.
• Keep track of payment deposits from patients and insurance reconciling details.
• Coordinates processes for reviewing, analyzing, and establishing fee schedules for Department and related Divisions. Assists with establishment of Department incentive system and ensure effective maintenance.
• Serves as a primary liaison between Department and internal & external entities. Serves as a departmental representative on appropriate committees and meetings. Interprets policies and regulations concerning department's financial activities, including university policies and procedures and Federal and State agency guidelines. Ensures compliance with applicable laws, regulations, policies, and procedures.
• Oversees and participate in quarterly financial reviews and annual audits with internal and/or external auditors.
• Scrub claims prior to submission, work clearinghouse rejections and errors, post both manual and ERAs while reconciling to ensure payments balance.
• Serves as the primary point of contact within the Finance structure of the department for evaluating all revenue functions and services.
• Directs and develops written justification to support budget proposals, expenditure items, and financial policy matters. Directs, manages, and supervises department's billing office. Develops and modifies patient billing procedures to allow optimum income generation. Assists in negotiation and establishment of contractual arrangements for professional services.

Master's degree from an accredited institution in an appropriate area of specialization and six (6) years of experience; or Bachelor's degree from an accredited institution in an appropriate area of specialization eight (8) years of experience required.

Preferred Qualifications:

Bachelor’s degree in finance, business administration, healthcare administration, or related field.

Experience in an academic medical center or hospital environment.

Relevant leadership experience.

Proven experience in healthcare billing.

Sound knowledge of health insurance providers.

Knowledge of HIPAA regulations.

Knowledge of Explanation of Benefits Statement (EOBs). Commensurate with Experience College of Medicine Clinical - Off Campus Location (COM use only) Monday - Friday, 8:00 a.m. - 5:00 p.m. 2023-08-15 Individuals with disabilities requiring accommodation, please call 561-297-3057. 711

Final candidate will be required to have official, sealed transcripts and original NACES evaluation, if applicable, sent from their educational institution to Human Resources prior to the start of employment.

Successful completion of a background check, which may include a motor vehicle check, credit check, fingerprinting or additional screening, is required for the selected candidate prior to the start date.

A resume is required for this position. Make sure to attach these required documents in the Attachments section of the application. Any missing required documents will result in disqualification.