Director of Revenue Cycle

4 weeks ago

Windsor, United States Southern New England Healthcare Full time $116,276 - $151,159
Job DescriptionJob Description

SUMMARY OF RESPONSIBILITY:

Reporting to the Chief Financial Officer, the Director of Revenue Cycle (DRC) will lead the Revenue Cycle team and manage all functions of the organization’s billing and revenue cycle to increase cash flow while maintaining and improving internal and external customer relations. The DRC will work closely with a variety of stakeholders including clinical operations, compliance, IT and finance to ensure alignment and integration of revenue cycle processes. This position leads in the development, analysis, and preparation of strategic Revenue Cycle metrics and reviews current operating results to achieve overall strategic goals and objectives.

This role is located at the company's headquarters in Windsor, CT, and operates in a hybrid/remote environment.

ESSENTIAL FUNCTIONS:

  • Implements best practices, monitors key performance indicators, and develops strategies to achieve operational success.
  • Develops, maintains, and improves the revenue cycle process in support of SoNE HEALTH’s growth.
  • Develops and manages operational initiatives with measurable outcomes.
  • Responsible for maximizing the productivity and minimizing the errors of the Revenue Cycle Department using structured auditing and reporting methodologies combined with follow-up training
  • Prepares and delivers reports to executive leadership outlining progress towards meeting quarterly/annual goals and objectives and performance.
  • Monitor and analyze areas of concern, identify trends, and implement corrective actions as needed.
  • Adheres to state and federal regulations to improve care, compliance, and reporting.
  • Reviews, designs, and implements policies and procedures to optimize the revenue cycle and ensure compliance in coding, billing, and collections practices.
  • Maintains appropriate internal controls and safeguards over allowances and write-offs; ensures compliance with department policies to guarantee proper review and approval of adjustments.
  • Functions as the leader or subject matter expert in Revenue Cycle data and tools.

Other Functions:

  • Performs other duties as assigned.

The duties listed above are intended only as illustrative of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar or a logical assignment to the position.

QUALIFICATIONS AND COMPETENCIES:

  • Bachelor’s degree in health administration, business, finance, or a related field
  • 7 - 10 years of progressive experience in healthcare revenue cycle management and at least 7 years of managerial/leadership experience
  • Strong understanding of healthcare billing, coding, reimbursement and regulatory requirements (i.e. Medicare, Medicaid and commercial payers)
  • Proficiency in electronic health records (EHR) preferably Athena
  • Thorough knowledge of patient financial services (PFS) processes and standards related to billing, collections and cash posting. General knowledge of patent registration, finance and data processing
  • Knowledge of healthcare compliance regulations (i.e. HIPAA, Stark Law, Anti-trust Kickback Statute) and experience of implementing compliance procedures is a plus
  • Advanced skills in Microsoft Office applications
  • Broad knowledge of Revenue Cycle operations
  • Demonstrated skills in A/R management and problem assessment
  • Experience in hiring, training, leading, and developing new Revenue Cycle team members
  • Strong attention to details and excellent communication skills
  • Certified Professional Coder (CPC), Certified Revenue Cycle Professional (CRCP) or other relevant certifications preferred

PHYSICAL AND MENTAL REQUIREMENTS:

The Physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Frequently is required to walk, sit, and stand.
  • Ability to transport and/or maneuver objects weighing up to twenty pounds.
  • Vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus.
  • The dexterity necessary to utilize a computer keyboard regularly is essential.
  • Busy work environment subject to frequent interruptions and shifting potentially conflicting priorities.


ADDITIONAL REQUIREMENTS:

  • As a condition of employment at SoNE HEALTH, all employees must reside in New Hampshire, Rhode Island, Maine, Vermont, Connecticut, or Massachusetts.
  • For the safety and well-being of our employees, all employees are required to be fully vaccinated for influenza.
  • If you will be working in a remote or hybrid capacity, we require a stable internet connection. We recommend that you have an internet service provider with speeds of at least 30Mbps download/5Mbps upload.

ADHERENCE TO THE SoNE HEALTH CODE OF CONDUCT:

  • Code of Conduct: Employee will understand and follow the guidelines and standards outlined in the SoNE HEALTH Code of Conduct and demonstrate an understanding of the SoNE HEALTH Mission, Vision, and Core Values.
  • Policies and Procedures: Employee will comply with all SoNE HEALTH policies and procedures relevant to their role, including those related to compliance, safety, and confidentiality.
  • Regulatory Requirements: Employee will ensure actions and behaviors are in accordance with applicable laws, regulations, professional standards, policies, procedures, and the Code of Conduct.

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