Vice President, Revenue Cycle Management

1 month ago

Tampa, United States Tampa Family Health Centers Full time
Job DescriptionJob Description

Position Summary

As the Vice President, Revenue Cycle Management, you will play a critical role in overseeing and directing all aspects of the revenue cycle, including billing, coding, collections, and support functions. You will report to the CFO and be responsible for identifying and prioritizing escalations, enforcing standard operating procedures, driving change management initiatives, and managing key performance indicators to optimize revenue cycle performance.


Essential Duties & Functions

1. Escalation Management:

- Identify the Return on Investment for open issues and prioritize them based on their impact on revenue cycle efficiency.

- Implement strategies to resolve escalations promptly and effectively.

- Serve as the primary point of escalation for customers.

2. SOP Adoption:

- Promote the adoption and adherence to standard operating procedures (SOP) within the revenue cycle department.

- Ensure that established procedures are consistently followed.

3. Change Management Execution/Enforcement:

- Lead and enforce change management initiatives within the revenue cycle department.

- Ensure that changes in processes and workflows are effectively communicated and implemented.

- Conduct root-cause analyses for identified issues or improvement opportunities to identify solutions.

4. Workflow and Standards Enforcement:

- Enforce workflows, standards, and timeframes to maintain consistency and efficiency in revenue cycle operations.

- Monitor compliance and promptly address deviations across all departments, promoting visibility of inter-departmental changes and functions.

5. Support Functions Management:

- Oversee support functions, including call center operations, coding, no response, and payment posting.

- Collaborate with team leads and managers to optimize support processes and align them with revenue cycle goals.

- Develop, evaluate, implement, and revise policies and procedures related to improvement strategies, cash posting oversight, and all other vendor-managed operations.

- Streamline processes and align them with best practices to enhance operational efficiency.

6. KPI Achievement:

- Meet or exceed defined monthly Key Performance Indicators (KPIs) related to revenue cycle performance.

- Continuously monitor and analyze performance data, identifying areas for improvement.

7. Regulatory Compliance:

Stay updated on reimbursement billing procedures of third-party and private insurance payers and government regulations.

- Ensure compliance with all pertinent guidelines and standards.

8. Monthly Reporting:

- Provide monthly reports on Key Performance Indicators to stakeholders.

- Summarize changes and trends, offering insights for performance enhancement.

- Perform monthly reviews of billing, coders, and collectors' productivity, including quality assurance.

9. Cross Functional Coordination

· Collaborate with Operations leadership, Clinic managers, Front Desk staff, Call Center staff, Providers, and the Credentialing team in order to improve the efficiency of the entire Revenue Cycle process. Each area will be made aware of training opportunities in order to correct or improve current workflows or knowledge gaps.

Essential Functions

· Direct monitoring related to revenue cycle management from pre-registration through final account resolution, including registration, coding.

· Propose and implement policies and procedures, work rules and performance standards to ensure the efficient and effective operation of the company’s Revenue Cycle departments in compliance with organizational standards, FQHC guidelines and federal, state and local laws.

· Develop, coordinate, evaluate and direct efforts of analysis to improve Revenue Cycle initiatives.

· Lead Revenue Cycle and clinic/provider process improvement activities, identifying areas in the Revenue Cycle that are not working efficiently or effectively as a result of ongoing analysis.

· Perform on-going monitoring and auditing of areas assigned to ensure appropriate documentation and coding acting as compliance liaison. Participate in annual department budget. Ensures that fiscal responsibility is exercised in all financial decisions.

· Implements retention strategies in coordination with HR/RCM management team.

· Maintain professional relationships with carriers, state partners etc.

· Demonstrate leadership skills in motivation, managing change, delegation, conflict resolution, and written and oral communication. Facilitate with other RCM management, regular staff meetings/training.

· Promote professional growth of self and staff.

· Develop and maintain team concept in departments. Motivates staff to continually move toward performance excellence.

· Foster effective working relationships with and among employees, as well as with customers and staff from other departments.

· Demonstrate knowledge of FQHC policies, procedures. Continue to maintain high level of knowledge in this area identifying upcoming changes and assist in preparing / training RCM team.

· Serve as a subject matter expert for department managers, staff, physicians, and administration for obtaining information or clarification on FQHC law, and regulatory requirements relating to RCM/Coding.

· Actively participates in various committees as needed.

· Oversee implementation and adherence to the Coding compliance and clinical documentation improvement programs


Required Education, Certifications, Licenses, & Training

Bachelor’s degree in healthcare management or business administration or related Master’s degree is preferred but not essential.


Required Years of Experience

Minimum of 8 years executive leadership within a revenue cycle function.

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