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Director Revenue Recovery
4 months ago
Department: Revenue Cycle Management
Employment Type: Full Time
Location: Ohio Revenue Cycle Management
Reporting To: Molly Gearhart
Description
The Director of Revenue Recovery has the responsibility for all payer related functions impacting
reimbursement across all medical/surgical locations of Midwest Vision Partners. This individual will
drive performance of insurance follow up, contract negotiating and maintenance, credentialing and
provider enrollment. The Director's responsibilities include accountability for ensuring maximum
reimbursement for the organization, setting key objectives, communicating with key stakeholders,
creating, updating and enforcing policies and procedures and achievement of key performance
indicators. The Director will be the expert in account receivable functions for the organization to
optimize revenue goals and drive teams and staff to achieve performance targets.
Key Responsibilities
What You Will Be Working On:
Performance
- Drive AR performance across all medical/surgical locations including physician practices, ambulatory surgical services and other service locations or service types
- Establish key objectives and set targets for key performance indicators
- Ensure compliant, accurate, timely and optimized collections of consistent expected payment and cash flow
- Establish workflow and review mechanisms to monitor and ensure expected outcomes
- Oversees payer contracting functions to develop and sustain payer relationships, creating a frictionless adjudication process
- Evaluates AR to identify and execute on strategies to improve overall performance and exceed national benchmarks for DOS, denial trends and aged AR percentages > 120 and 365 days Leadership and Management
- Builds a strong team which works collaboratively with internal and external departments
- Effective management of capital and human resources to ensure performance standards are consistently met
- In conjunction with the Director of RCM Operations, establishes staff assessment, training and performance monitoring programs and ensures adherence of staff Identify training needs, skill development opportunities, and create an educational plan Communication and Working Relationships
- Appointed RCM Leader working directly with Accounting and Finance teams to provide routine accounts receivable updates, cash flow projections and ensure timely and complete resolution of claims
- Identifies and collaborates with appropriate leaders on strategies to reduce denials and ensure maximum collections
- Creates and presents monthly performance documentation for the platforms focusing on performance, advising on workflow improvements and establishing a presence as a resource to patients, providers and staff
- Organizational point of contact with payer relations representatives at all major payers to maintain strong collaborative relationships allowing for efficient and effective escalation and resolution of issues negatively impacting receivables
- Actively understands payer and regulatory trends with the ability to develop strategies with appropriate leaders to activate tactics to mitigate risks
- Remains current with governmental, payer and organizational policy changes applicable to all states in which services are provided
- Participates in professional development activities and maintains professional affiliations
- 10+ years in healthcare or related industry experience with an emphasis on Revenue Cycle
- Management
- 5+ years in payer contracting or negotiating
- 5+ years in a supervisory role
- Excellent knowledge of governmental and 3 rd party reimbursement structures
- Experience with functioning as a key member of the leadership team with responsibility of encouraging proactive response to operations
- Proven track record of achieving industry standard benchmarks
- Excellent analytical, problem-solving and organizational skills
- Education and Skills
- Bachelor Degree preferred in business, health administration or accounting
- Demonstrated ability to use PCs, Microsoft Office suites with advanced Excel capabilities
- Kronos, AllScripts, Nextech, Payer Path experience preferred
