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Sr. Director – Revenue Cycle Management

Sr. Director – Revenue Cycle Management

CompanyPrivia Health
LocationDeSoto, TX, USA
Salary$128000 – $132000
TypeFull-Time
DegreesBachelor’s
Experience LevelSenior, Expert or higher

Requirements

  • Bachelor of Science/Business Administration degree preferred
  • Experience in managing physician revenue cycle. Thorough understanding of all payers including all major commercial payers as well as Medicaid and Managed Medicaid across multiple markets.
  • Must have experience with AthenaHealth
  • Strong and effective results-oriented team leader with a minimum of seven years of experience managing large, multi-specialty physician groups (50+) of varying levels of complexity
  • Excellent analytical skills, facile with Microsoft Excel.
  • Must be able to critically evaluate data and make recommendations for change based on solid research and evidence.
  • Solid knowledge of industry trends, regulations, payment models and demonstrated skill in managing in a complex reimbursement model across multiple provider specialties.
  • Must possess a thorough understanding of medical information systems for billing and accounts receivable, spreadsheet analysis, reporting applications, medical terminology, and coding and office procedures.
  • Successful history of adding value to organizations through proactive root cause analysis and resolution of bottlenecks that negatively affect reimbursement and accounts receivable.
  • Demonstrates a record of significantly improving patient accounts receivable.
  • Must comply with HIPAA rules and regulations.

Responsibilities

  • Oversees and manages end to end Revenue Cycle Management for assigned markets and other national RCM projects.
  • Serves as the senior subject matter expert on all issues surrounding payer reimbursement, accurate claim processing, claim submission, collections and other general revenue cycle management.
  • Responsible for root cause analysis and resolution of market issues, and escalating issues to RCM and Market Operations leadership, as necessary.
  • Serves as the liaison to market or national committees such as Compliance, Payer & Audit and other committees as assigned.
  • Conducts both weekly standup and monthly staff meetings.
  • Provides management, guidance and training to staff and will perform duties of staff when necessary to maintain practice operations.
  • Reviews daily, monthly and weekly A/R dashboards. Identifies opportunities for improvement and develops plans to implement necessary changes to meet performance expectations.
  • Participates in annual budget development, and is accountable for departmental adherence to budget and/or other fiscal goals.
  • Manages teams responsible for the accuracy and financial viability of the accounts receivable. Assigns/allocates resources as required ensuring company goals for aging and accounts receivable days are met.
  • Reviews accounts receivable on at least a monthly basis with each Market President and Regional Vice President to ensure A/R is within established standards.
  • Works with RVPs, Market Presidents and subordinate staff to create action plans to address variances in A/R to standards.
  • Responsible for departmental policies and procedures, providing recommendations when appropriate and ensuring compliance.
  • Responsible for staffing to include hiring, termination, coaching and training.
  • Provides ongoing feedback to staff of performance throughout the year to subordinate staff.
  • Counsels employees in disciplinary matters and obtains assistance from human resources appropriately for disciplinary actions and/or employee termination process.
  • Recruits, interviews and hires personnel as necessary.

Preferred Qualifications

    No preferred qualifications provided.