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Director of Revenue Cycle
4 months ago
Position Summary: The Director of Revenue Cycle is responsible for maximizing the collection of medical services payments and reimbursements from patients, insurance carriers, financial assistance, and guarantors. Responsible for insurance eligibility processes, charge processing, claim submission and processing, payment processing, collections and accounts receivable management, denial management, proper coding, credentialing, customer services relative to revenue cycle, and training and development relative to revenue cycle staff.
Duties and Responsibilities
- Hire, train, supervise, and evaluate all staff in the Billing Department.
- Enrollment and credentialing of all provider types at all PrimeCare locations and with all insurance carriers, including Medicaid and Medicare.
- Assist in preparation of UDS reports.
- Prepare monthly statistics, as requested.
- Develop and foster relationships with insurance carriers.
- Updates PrimeCare’s Fee schedule on a yearly basis.
- Develop relationships with insurance carriers.
- Within six months of employment assume responsibility for referral coordination
- Other duties and responsibilities as assigned.
Required Skills or Abilities
- Ability to work in a diverse organization as a team member.
- Present a positive, professional image to persons who have diverse interests and ideas.
- Proficient in Microsoft Office products and familiarity with utilizing an Electronic Health Record (EHR).
- Proven ability to communicate and foster effective working relationships.
- Ability to plan, organize, and prioritize workloads with minimum direction.
- Must be able to cover other shifts as necessary.
Qualifications, Knowledge, Experience, or Licensure
- Bachelor’s degree in business administration, accounting, or finance strongly preferred.
- 10 – 15 years of experience in outpatient clinics, especially with federally qualified health centers (FQHCs) strongly preferred.
- Prior experience with Medicaid, Medicare, financial assistance, and commercial insurance plans required.
- Prior experience with Athena strongly preferred.
Physical Demands
- Must be able to remain in a stationary position 50% of the time.
- Must be able to move around the clinic site 50% of the time.
- Constantly operates a computer, computer printer, copy machine, and telephone.
- Occasionally positions self to maintain exertion of physical strength to move objects of 10 pounds from one level to another.
- Must be able to transport from one site to another.
Benefits
- 27 days of PTO each year, accrued each pay period
- 3 personal days
- 1 floating holiday
- 7 paid holidays
- Medical/Dental/Vision coverage available the 1st of the month following 30 days
- Company-paid life, short-term disability, and long-term disability coverage
- Discretionary 403(b) match and profit sharing after meeting service requirements
- Flexible spending accounts
- Accident & critical illness coverage
- Pet insurance
