Assistant Director, Revenue Cycle Optimization

1 week ago

San Antonio, United States MPOWERHealth Full time

For over a decade, MPOWERHealth has supported the independent musculoskeletal physician with best-in-class clinical services, back-office solutions, and advanced technology. We pride ourselves on being a partner that offers foresight to customers. We simplify what’s complex, and we help them find a better way. Our best-in-class analytics coupled with industry-leading expertise make MPOWERHealth the company our customers can rely on no matter what lies ahead.


Job Summary

The Assistant Director of Revenue Cycle Optimization is an expert in the revenue cycle process beginning to end, has an intimate understanding of how to review, optimize, implement, improve, and educate on standard operating procedures, and is an expert at influencing individual behavior through partnering with other leaders and providing education to ensure strict adherence to standard processes. The Assistant Director’s work is dedicated to deep understanding of revenue cycle in its optimized state and improving the revenue cycle process entirely measured by revenue and CPT allowable success. Assistant Director will be responsible for collaborating with RCM leadership to design, implement, train, and report on solutions and/or team performance to meet business objectives. They identify workflow improvements, present recommendations, execute plans, and report on outcomes. The Assistant Director creates and maintains SOPs, workflows and other documents needed for all RCM functions and monitors teams’ activities to ensure processes are being followed. They will be assigned projects to manage from beginning to end, ensuring they are planned, documented, executed, monitored and reported to completion.


Essential Job Duties and Responsibilities

Leadership

  • Assistant Director will operate as a strategic individual contributor with the ability to create/build long term strategic plans while also being able to home in on a granular level across the RCM business.
  • Assistant Director will have the ability to influence and guide other leaders without any direct reporting authority.
  • The Assistant Director will not initially have direct reports but will have past experience leading teams and influencing the success of teams.

Denials Management

  • The Assistant Director will work to gather data, analyze and identify improvements needed within RCM to decrease denial and no response rates.
  • Partner with RCM Leadership to share findings and recommend changes to improve the allowed CPT rate
  • Conduct regular proactive review of data regarding denials and insurance trends, reporting findings promptly along with recommendations and ideas.
  • Monitor implemented changes to measure impact and report on outcomes. Alert leadership if a change is having unanticipated negative results so that concerns can be addressed timely.
  • Report routinely to Sr. RCM leadership and/or executive team on revenue cycle performance regarding quality and optimization of revenue and/or CPT’s

M&A Diligence and Integration Support

  • The Assistant Director will provide support at direction of leader to review data, follow up on diligence, analyze reports, case logs, workflows, review any contracts to best understand how we can successfully integrate companies being diligenced and identify and mitigate any risks during the diligence phase.
  • They will work with RCM Leadership to plan and execute integration and onboarding upon successful M&A activities.
  • Keep utmost confidentiality around any and all M&A activities or

SOP and Workflow Development

  • The Assistant Director of Revenue Cycle will review existing processes and policies within RCM and provide input and recommendations on improvements for existing processes as well as identify gaps within RCM.
  • Ownership of SOPs to ensure they are maintained, accurate, and integrated into the daily operations of the business.
  • Will collaborate with leadership to draft, revise, implement and train on SOPs and
  • The Assistant Director will monitor RCM activities to ensure the documented processes are being followed and meet current business needs.

Medicare Management Excellence

  • Ensure routine Medicare billing processes are followed, executed and collected
  • Review Medicare billing processes to ensure compliance with Federal
  • Work to solve any gaps identified and execute on work needed to ensure RCM is collecting on all Medicare cases to the maximum extent possible.

RCM Reporting

  • Partner with leadership to proactively review routine reports, share insights, propose and partner with RCM leadership to implement solutions.

Other Areas of Focus as needed

  • Identify and execute improvements through regular and frequent review of
  • Identify areas for increased efficiencies and process failures as soon as possible, provide information and recommendations to leadership to address as needed.
  • Recommend and incorporate strategic planning of major projects and identify areas needing performance improvement.
  • Monitor the performance of revenue cycle activities utilizing monitoring tool sets, data and performance metrics.
  • Study current Revenue Cycle best practices, to ensure company leadership is aware of leading-edge technology and processes.

Actively engage to stay on top of current industry trends and compliance

  • Provide support to RCM leadership team at direction of leader to fill any leadership gaps during absences.
  • Build, promote, and encourage a positive culture with team engagement, employee recognition and support to overcome hurdles.
  • Other duties as assigned


Qualifications

Education and/or Experience

  • Experience in all areas of Revenue Cycle management, 5+
  • Management experience, 2+ years
  • Bachelor’s degree, equivalent experience

Skills/SpecializedKnowledge

  • Current knowledge and skills in the following: medical billing practices, quality control, claims processing, billing resolutions, and experience managing staff members.
  • Knowledge of laws that regulate communication and privacy HIPPA laws and understanding of the application of all the above.
  • Experience with MS Office applications including Word, Excel, Access, &
  • Demonstrates a sense of urgency and ability to meet
  • Outstanding communication, presentation, and relationship-building skills; able to engage with all levels of an organization.
  • Ability to manage multiple priorities in a fast-paced environment and exercise independent judgement on matters of significance.
  • Knowledge of medical terminology, CPT, and ICD-
  • Knowledge of insurance industry, including legal and regulatory government provisions as related to health care industry.
  • Knowledge of labor regulations and employee relations

Other Requirements

  • Must maintain professional
  • Ability to be at work at regular and consistent
  • Some travel

Physical and Mental Demands

This position involves prolonged sitting and use of office equipment and computers. It may also require occasional light lifting (up to 20 pounds), reaching, stooping, standing, and walking. The role demands strong communication, analytical, and coordination skills. Reasonable accommodation will be provided for individuals with disabilities.

Work Environment

  • Standard office environment with the option for a limited hybrid schedule as determined by the needs of RCM.

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