Revenue Cycle Director

2 days ago

Irving TX United States Lifecare Home Health Family Full time

Description

Job Description :

We are looking for a reliable and compassionate Revenue Cycle Director for home health to join our team.

Why Lifecare Home Health Family?

Join our team at Beyond Faith Homecare and be a part of a company that strives to provide the best care for our patients while building a team of dedicated employees. If you want a company that appreciates your skills, compassion, and heart, then Lifecare Home Health Family is the place for you We take pride in not only providing excellent care to our patients but also creating a positive team environment with employee support.

We provide:

  • Competitive base Pay
  • Medical, Dental, Vision
  • 401 (K), Flex Spending
  • Life Insurance
  • Short- Long-Term Disability
  • Mileage Reimbursement
  • PTO
  • Team Events
  • Recruitment Incentive Program
  • Continuing Education Training
  • Employee Recognition Programs
  • Performance Incentives
  • Family Team Environment

General Summary:

The Revenue Cycle Director is responsible for overseeing revenue cycle management including coding, billing, collections, and denial management, and is primarily responsible for Cash Flow. The position is responsible for ensuring claims, denials, and appeals are efficiently processed, and resolving billing-related issues. The Revenue Cycle Manager will minimize bad debt, improve cash flow, and effectively manage accounts receivables. This role will also manage Provider credentialing. This position is to stay apprised of coding and revenue trends; and is responsible for coding education to clinical and coding/billing staff. In addition, this position will manage all Revenue Cycle Management staff including billers and coders.

Essential Functions:

  1. Oversee and manage entire revenue cycle including billing, coding, collections, and denial management.
  2. Communicate professionally with various payers.
  3. Manage, develop, and mentor all revenue department staff, including billers and coders and RCM/Admissions Supervisor.
  4. Responsible for management and maintenance of billing and practice management software platform.
  5. Provide up to date education for clinical, billing, and coding staff on coding trends.
  6. Develop, evaluate, implement, and revise policies and procedures related to billing, coding, reimbursement activities and improvement strategies.
  7. Reconcile all receivables and revenue reports and work closely with the finance department in the development of the monthly financial statements.
  8. Manage and update the charge master based on the current CMS fee schedule and negotiated contracts.
  9. Conduct monthly analysis of Medicare/Medicaid/Third Party Payers.
  10. Oversee the processing of credentialing and provider enrollment applications, initial, and re-enrollment status with all Medicaid, Medicare, and Commercial Payors.
  11. Responsible for the generation and management of revenue, admissions, and credentialing metric reports.
  12. Review and resolve issues related to claim generation and rejected/denied billings.
  13. Commit to highest level of business and patient confidentiality possible adhering to all HIPAA and security guidelines when accessing and sharing patient information.
  14. Keep abreast of all reimbursement billing procedures of third party and private insurance payers and government regulations.
  15. Maintain appropriate internal controls over accounts receivable, RCM process.
  16. Monitor accounts sent for collection and reimbursements from insurance companies and other third-party payers.
  17. Review, monitor, and evaluate third party reimbursement and research variances.
  18. Participate in the development of coding and billing strategies, evaluating process relative to revenue cycle, and making recommendations while ensuring compliance with any relevant rules or regulations (including HIPAA, Medicaid, Medicare, and specific 3rd Party Payors).
  19. All other duties as assigned.

Requirements

Required Experience:

  • A bachelor’s degree and 3-5 years of related work experience (or equivalent experience; 15-20 years of HH Revenue Cycle Experience as a Director or Above).
  • Knowledge of third-party payer requirements including federal, state, and private health care plans and authorization process.
  • Proven experience in home healthcare billing, including Medicaid/Medical Assistance.
  • Knowledge of basic insurance policies, procedures, and reimbursement practices with Medicare coding.
  • Experience supervising staff.
  • Prior experience with process development and execution.
  • Excellent communication and interpersonal skills.

Preferred Experience and Qualification:

  • 3 years healthcare experience at the management level (15 if no degree).
  • Wellsky Experience.
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