Director Revenue Cycle Management

At Cleveland Clinic Health System, We Believe In A Better Future For HealthcareAnd each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day.We all have the power to help, heal and change lives beginning with our own. That's the power of the Cleveland Clinic Health System team, and The Power Of Every One.Job TitleDirector Revenue Cycle ManagementLocationClevelandFacilityRemote LocationDepartmentRCM Billing and Follow Up PB-FinanceJob CodeT38105ShiftDaysSchedule8:00am-5:00pmJob SummaryJoin the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will receive endless support and appreciation and build a rewarding career with one of the most respected healthcare organizations in the world.The Director of Revenue Cycle Management provides direct supervision to Revenue Cycle managers and supervisors overseeing the organization's professional accounts receivable. Responsibilities include monitoring integrated Revenue Cycle activities such as billing and no-response follow-up. This leader is also responsible for establishing and implementing policies and procedures and for developing and maintaining effective controls over all back-end Revenue Cycle functions. A caregiver works remotely from 8:00 a.m. 5:00 p.m. A caregiver who excels in this role will:Develop departmental goals, plans and standards consistent with the clinical, administrative, legal and ethical requirements/objectives of the organization.Plan, organize and direct all activities related to staffing, including hiring, orienting, evaluating, disciplinary actions and continuing education initiatives.Prepare departmental budgets and ensure that the department operates in compliance with allocated funding.Coordinate and direct internal/external audits.Serve as the primary liaison for resolving issues and escalations, coordinating between internal teams and external stakeholders to ensure timely and accurate billing.Knowledgeable of all billing and follow-up regulations for each of the respective payers. Knowledge level should be such as to allow the Director to educate departmental personnel of regulations and allow the Director to understand the financial impact of regulatory changes.Monitor denial trends, drive mitigation efforts, resolve issues and support cash flow by overseeing collections across assigned work groups.Oversee daily billing operations and collections to drive timely reimbursement.Demonstrate broad knowledge of applicable statutory, regulatory and administrative requirements relative to departmental operations and ensure compliance with the same.Responsible for continuously monitoring the effectiveness of policies and procedures, ensuring that billing is in compliance with all federal, state, and other regulatory requirements.Make recommendations to Administration relating to improving functions of Revenue Cycle.Responsible for determining when appropriate to develop and implement new policies and/or procedures as appropriate.Collaborate with third-party payors, medical staff, administrative staff, department managers, community leaders and other to assist with meeting operational needs of Revenue Cycle Management.Minimum qualifications for the ideal future caregiver include:Bachelor's degree and seven years of experience in a large clinic/group practice or hospital patient accounting operationsOR Associate's degree and nine years of experienceOR High School diploma/GED and 11 years of experienceExtensive experience in insurance receivables, including both billing and follow-up to ensure timely reimbursementPreferred qualifications for the ideal future caregiver include:Vendor relationship experienceStrong RCM Back End experience (Physician or Hospital Billing Experience)Strong knowledge of EPICSuccessfully managed large remote teams Physical Requirements: Ability to communicate and exchange accurate information.Ability to perform work in a stationary position for extended periods.Ability to work with physical records or operate a computer or other office equipment.In some locations, ability to travel throughout the hospital system.In some locations ability to move up to 25 lbs. Personal Protective Equipment: Follows standard precautions using personal protective equipment as required.The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our drug free environment. All offers of employment are followed by testing for controlled substances.Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption.Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility.Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities.