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Director of Finance and Patient Revenue

3 months ago

Columbia, United States AbsoluteCARE Inc Full time

Job Summary

The Director of Finance and Patient Revenue oversees all financial aspects of AbsoluteCare's member billing process, with primary responsibility for payer contract relationships, negotiation, and performance adherence. This role also manages financial outcomes in partnerships with federally qualified health centers. The Director communicates effectively, coordinates, and implements essential processes and procedures across departments and medical services to ensure timely patient billing and payment processing in line with policy. They work to minimize bad debt, improve cash flow, and effectively manage accounts receivable. Additionally, this position coordinates revenue cycle activities, including front desk operations, billing, collections, financial counseling, and staff training. Ensuring accuracy in deposits, demographic information, and other data entered into the patient billing system is paramount. The Director participates in program evaluation activities, facilitates service changes based on Continuous Quality Improvement results, and prepares status reports for management analysis. Monitoring data integrity for the practice management system and reporting problems promptly are key responsibilities, along with providing monthly reports on credit balance status.

Duties and Responsibilities

  • Establish key performance indicators (KPIs) and metrics to track payer operations and revenue performance, identifying areas for improvement.
  • Analyze payer reimbursement patterns, denials, and claims data to identify trends, areas for improvement, and revenue enhancement opportunities.
  • Cultivate and maintain strong relationships with current partnerships payers and FQHCs - to optimize accurate and timely reimbursements through various payer programs.
  • Stay abreast of relevant healthcare regulations, billing guidelines, and payer policies to ensure compliance with industry standards and adapt to changes.
  • Collaborate with other departments, such as Operations, Finance, Member Engagement and Clinical Teams, to implement strategies that optimize revenue growth and minimize revenue leakage.
  • Lead large, cross-functional operations projects by gaining executive alignment, establishing clear timelines and outlining key requirements.
  • Define and lead the process for leveraging external resources (e.g., vendors, contractors) to support payer operations.
  • Support Payer teams in late stage opportunities as they define integration and operational requirements.
  • Develop and implement practice-specific process improvement recommendations to secure positive results, monitor performance and improve resolution plans for unfavorable trends.

Minimum Qualifications

  • Bachelor's degree in Business Administration, Health Care Administration, or related field.
  • Five to Seven years of experience in Revenue Cycle.
  • Two years of management experience in a healthcare setting; or Master's Degree in Health Administration, Public Health, Business, or related field and one year of experience.
  • Preferred certification in ICD-10 medical coding.
  • Ability to function with minimal direct supervision.
  • Proficiency in using personal computers and various programs and applications required to perform job duties effectively.

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