Director of Revenue Cycle Operations
2 weeks ago
This key leadership position will be responsible for overseeing all revenue cycle activities including submission of claims and filing procedures as well as ensuring billing operations are performed in an accurate and timely manner. The Director is responsible for building and leading a high-performing team with a “customer-centric” leadership approach enabling ExpressCare to achieve its overall strategic and financial goals. This candidate must be familiar with ICD-10, CPT & HCPCS coding and will be responsible for analyzing revenue and collections trends to optimize efficiency and reduce overall accounts receivable. This person will also oversee provider and new clinic credentialing activities including maintenance of provider CAQH accounts and enrollment with various payers the group participates with. This position is on-site in our Bel Air location.
Responsibilities
Oversee day-to-day billing operations including but not limited to payment posting, claims follow up and appeal, accurate charge entry and submission.
Develops and implements onboarding, training and education of assigned operational staff to ensure talent development and optimal performance.
Review and develop strategies to increase productivity and efficiency, work down AR and distribute work accordingly.
Review bank activity including reconciliation of insurance and patient payments between bank and practice management system.
Oversee production of medical records for external vendors including 3rd party insurance, attorneys, disability determination, HEDIS and payer audits while maintaining compliance with standards and regulations.
Credential new providers and locations with participating insurances and maintain their enrollment status.
HR functionalities including hiring new employees, conducting performance reviews, managing employee disputes and review of time off requests and time clock issues.
Work collaboratively with other department leaders to solve patient issues in a customer centric manner.
Pull routine reports to evaluate billing processes and trends and leverage business intelligence tools to assist with revenue cycle analytics and other intricate reporting requests.
Perform month end close activities and report on pertinent KPIs.
Work with 3rd Party vendors to enhance billing efficiency and optimize collections.
Assist with payer contracting, rate renegotiations and other insurance payer related issues.
Complete EDI, EFT and ERA enrollment with new and existing insurance payers.
Research and resolve insurance payer issues impacting claims reimbursement.
Oversight of billing staff including assisting with patient billing questions and phone calls.
Minimum education and professional requirements include but are not limited to:
Management and leadership experience, required
Knowledge of ICD-10, CPT & HCPCS coding, required
Coding credential preferred (CPC, CCS, RHIA, etc.)
Relevant revenue cycle management experience, preferred
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