Director of Revenue Cycle Management

4 weeks ago

Arlington, United States CareerBuilder Full time

The Director of Revenue Cycle drives and directs reimbursement/revenue cycle strategy and operations for all of Advantias Practices

that operate within multi-state locations. The position is responsible to oversee the functions and performance of the revenue cycle to include the effective management and guidance of receivables. This position is also responsible to ensure that all billing and collections are in accordance with company policies and procedures, regulatory requirements and guidelines.

This position works closely with R1, Athena, Payer Strategy and Negotiations, and internal billing teams to ensure billing and collections are in accordance with contracted and negotiated agreements. The Revenue Cycle Director reports to the VP of Revenue and works closely with the corporate finance team to provide accurate documentation of accounts receivable reports, revenue analytics and roll forward of balances for all legal entities and the company.

Job Duties:

Oversees the revenue cycle and receivables management operation allowing for maximization of revenue.

Ensures compliance with all pertinent company and regulatory requirements, policies and guidelines.
Supports the Accounts Receivable Accounting team by providing guidance and subject matter expertise, as needed, to establish effective and efficient functioning of the reimbursement function.
Acts as key owner of revenue cycle performance and coordinates activity and communication with external vendors (R1, Athena, etc) and internal stakeholders and teammates.
Monitors all major issues impacting reimbursement operations and collections, ensuring appropriate actions are taken to address identified issues and providing guidance, planning and expertise as necessary to ensure an effective and suitable resolution.
Ensures all major third-party payer reimbursement issues are addressed and resolved appropriately and according to the established policies and procedures.
Ensures management is informed regarding all major issues impacting the revenue cycle billing and collections.
Ensures that accounts receivable trends are closely monitored and that the appropriate decisions and actions are taken promptly to remedy operational and collection problems.
Ensures identified audit and compliance issues are addressed and corrected.
In collaboration with CFO, oversees the monitoring of bad debt reserves, contractual and write-offs.

Monitors revenue cycle performance metrics to drive continuous improvement efforts in all areas of the revenue cycle providing regular updates to the VP of Revenue.
Monitors and manages performance of front end revenue cycle operations, to include eligibility, pre-certification, copay and outstanding balance collection.
Provides monthly reporting on practice revenue cycle performance to all key leaders, including practice managers, physician managers, operations leaders.
Contributes to the compliance with, and development and updating of, company and department standard operation policies and procedures.
Develops and maintains external professional relationships with payers, professional associations, regulatory agencies, external auditors, vendors, and other healthcare organizations to monitor and influence external forces impacting company receivables and reimbursement.
Coordinates with payor relations to provide payor issues and pertinent information to help drive the corporate payor strategies
Other duties assigned

Job Qualifications:

Bachelor's degree in a health-related field or business administration; MBA or advanced degree desirable
10+ years of revenue cycle experience leading a central billing office
7+ years of experience as a manager or senior manager
Knowledge and experience in revenue accounting and revenue cycle best practices
Analytical skills to interpret and report monthly revenue results
Ability to present financial data and payor reimbursement information to physicians and executive management
Strong ability to multi-task in a fast-paced environment
Well-organized with ability to prioritize
Strong organizational, written and oral communication skills
Managed care contracting knowledge
Attention to detail and problem-solving ability
General knowledge of the Centers for Medicare & Medicaid Services (CMS) regulations
General knowledge of Adobe PDF Pro, Excel, Word, PowerPoint and Outlook

Please note:

Advantia Health is dedicated to providing unparalleled healthcare to our customers by employing the most highly-qualified individuals. If you are selected for further consideration, you will be subject to a background investigation. COVID-19 and Flu vaccination is a required condition of employment.

Advantia Health is an Equal Opportunity Employer that is committed to global diversity:

It is a place where good people want to work, and customers want to continue to engage EOE M/F/D/V.

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