Director – Revenue Cycle Management – Employer Services

Director – Revenue Cycle Management – Employer Services

Requirements

• 5+ years’ experience in leadership of Revenue Cycle, with in-depth working knowledge of Occupational Medicine/Workers Compensation billing and the insurance industries including reimbursement, EDI and electronic remittance processing.
• Experience with managing off-shore/remote teams.
• Experience in a growing healthcare environment.
• Strong working knowledge of the end-to-end revenue cycle from: charge master; health information; patient registration; coding; insurance verification; billing and claims processing; accounts receivable management; adjustments; remittance processing; and collections.
• Strong working knowledge of EMR and other systems and technology that drives efficiency, productivity, and cost effectiveness.
• Proficient in Microsoft Office, including Excel, Word, and PowerPoint.
• Knowledge of basic accounting principles.
• Excellent oral and written communications, interpersonal and organizational skills.
• Ability to read and analyze contracts.
• Can conduct financial analysis of Revenue Cycle protocols.
• Multiple project leadership, business partnering and cross department/matrix collaboration.
• Self-management abilities and sound business judgment.
• High level of experience and expertise with related software.
• Flexibility to support and to adapt to change.

Responsibilities

• Manage and/or assist in key department or cross-functional projects.
• Developing a strong sustainable team by attracting, developing, rewarding, and retaining talent.
• Motivates diverse teams by exemplifying the company vision, mission, values, and culture.
• Directs the development of training critical to the team’s success.
• Forecasts department staffing needs and manages staffing levels, with a strong focus on developing and retaining strong talent.
• Helps develop and manage the department financial budget.
• Works across the organization (field teams and practice support teams) to develop best-in-class practices that support best-in-class results.
• Collaborate with shared services functions that directly or indirectly support the revenue cycle function for WellNow.
• Develops the service practices required to meet the high expectations of the organization.
• Manage the EMR system and vendor, ensuring functionality and efficiencies are optimized. Effectively solve system issues internally or with third party vendor and extract data and perform analysis as needed.
• Ability to make recommendations for solutions that meet organizational goals.
• Supports the maintenance and inputs of the monthly Accounts Receivable bad debt allowance and contractual allowance, and provides insights and commentary on specific collection issues.
• Assist in month end close and reporting responsibilities, systems close and maintenance, report reconciliation and review.
• Leads through continuous improvement to ensure optimal processes and controls are in place and aligned with Company growth.
• Develop and lead effective cross-functional provider credentialing and enrollment processes.
• Prepares information reports and analysis of system data utilizing ERM software and other tools for monthly management reporting. Present monthly RCM reporting to management.
• Analyzes Accounts Receivable Agings, recommends changes in course of action.
• Creates and manages department key performance indicators / metrics to monitor the effectiveness of collection efforts and timeliness of client/insurance billings.
• Leads meetings with Occupational Medicine Sales team, providing status updates on projects, client issues and general reporting on receivables.
• Monitors industry and regulatory trends, develop and communicate plans to manage the impact.
• Participate in client negotiations, review contracts with clients oversee resolution of contract payment issues, and assisting in collection efforts.
• Vendor management, from sourcing, recommendations, negotiations, implementation, and auditing of contracted pricing arrangements.
• Assist in external financial statement audits, insurance audits/inquiries, and internal compliance requests.
• Committed to the specialty of Urgent Care and Employer Services, with a focus on serving our communities with quick, convenient and quality care with continued clinical and patient experience training.

Preferred Qualifications

• Associate or Bachelor’s degree preferred.