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Revenue Cycle Director

1 month ago

Braintree, United States Vitra Health Full time
About Us:

Vitra Health is a Home Health Care and Adult Day Health organization that specializes in care management of adults and seniors. We are a rapidly growing company which was started to improve access to quality home health care services. We rate ourselves solely by the quality of care we provide our clients. We realize that our clients are someone's parent, grandparent, child, friend, or neighbor - we pride ourselves on never taking this fact for granted.

Director of Revenue Cycle Job Summary

The position leads all activities, processes, and functions of Revenue Cycle Operations for Vitra in accordance with all state and federal regulatory mandates and best practices. In addition, the position is responsible for tracking and maintaining all key revenue cycle metrics and proactively identifies revenue and process opportunities.

Key Responsibilities

  • Scrutinizes and creates reports to identify trend and process gaps;
  • Identifies and resolves issues with individual insurance companies' accounts receivables, and preparation of monthly reconciliation;
  • Maintains knowledge of State and federal billing regulations, CPT and ICD9 codes, and provides supervision and guidance to revenue cycle accordingly;
  • Continual review of the revenue cycle to identify areas which need improvement to ensure that all appropriate avenues of revenue are being billed, appropriate reimbursement is obtained, and that continual improvement occurs;
  • Reviews aging monthly with finance leadership with the intent of keeping third party receivables over 180 days (about 6 months) to a minimum and total days outstanding under 60 days (about 2 months);
  • Ensures all charges are posted within five days;
  • Closes system within seven working days after month end;
  • Responds to, and provides guidance to, address inquiries and requests from clients and third-party payers and resolves/follow-ups with policies;
  • Provides training of staff and software and knowledge of regulations concerning their areas of responsibility;
  • Meets weekly with staff to foster communication on issues, ongoing training, and problem solving;
  • Provides guidance and management to staff on issues related to maximizing revenue and services provided, and to support accurate documentation and data collection reflecting services;
  • Participates in meetings with management, supervisors, and other departments to represent client account activities;
  • Interviews, selects, makes recommendations and important personnel actions and procedures related to patient accounts staff, and evaluates staff on an annual basis;
  • Before month closes, writes-off all cap and free care charges;
  • Performs other job-related duties as required or assigned;
  • Serves as a liaison with operations team;
  • Ensures revenue cycle team maintains denial management and rules building to ensure accounts are processed accurately;
  • Monitors the payment reconciliation process with the accounting department for accuracy and compliance;
  • Sets up the reporting system for data controls to identify and correct operational issues;
  • Maximizes the electronic collection process for patient accounts over 60 days (about 2 months); and,
  • Creates and maintains monthly reports to ensure best practices functionality are being followed;
  • Interacts with Vitra departments and outside vendors and payer representatives to address account resolution barriers;
  • Supervises month end revenue cycle processes;
  • Monitors the billing staff activity, accounts receivables, and denials;
  • Maintains and shares current knowledge of billing regulations;
  • Responds to and facilitates staff response inquiries and requests from clients and third-party payers;
  • Reviews or supervises review of accounts with staff and reviews write-offs with Controller;
  • In collaboration with finance leadership, supports negotiations with payers and development of contracting strategies;
  • Supports, develops, and engages with Leaders in their various functional areas throughout the organization to optimize revenue operations in their departments;
  • Foster culture of customer service and commitment to quality care;
  • Serve as a brand ambassador for Vitra reflecting our vision, mission, and values;
  • Show a genuine interest and compassion for the communities we serve and commitment to the diversity of our clients and team members;
  • Mentors and supports team members;
  • Other duties as assigned;
  • Creates and maintains monthly reports to ensure best practices functionality are being followed
Competencies Required:
  • Patient accounting or business services department in a health care related field
  • Data processing and billing systems as they relate to health service financial accounting and billing
  • Principles of patient relations and customer service
  • Principles and practices of continuous quality improvement
  • Requires the ability to develop policies, procedures and processes
  • Ability to analyze data and interpret statistics; to create a variety of narrative, statistical, and reports, including trend analysis; to identify and resolve problems; and to interpret guidelines and regulations
  • Basic methods and procedures of financial record keeping
  • Microsoft Word and Excel
  • Standard accounting procedures in relation to billing, collections, and health center revenue cycle
  • Federal, State, and private health insurance programs, billing, eligibility standards, and coding
  • Emerging trends regarding clinical, educational, and technological developments in the health care industry
  • Principles and practices of organization, administration, personnel management, labor relations, cost center management, and budgeting; and,
  • Principles and practices of conducting and responding to internal and external fiscal audits


Education and Experience Requirements:

Education: Possession of a bachelor's degree from an accredited college or university with a major in business administration, finance, accounting, health care administration or a closely related field.

Experience: Three (3) years of full-time or its equivalent experience in an administrative, managerial, or supervisory position with direct responsibility for delivery of patient business services, patient accounting services, insurance billing services, collection services or patient financial counseling services in a health care services organization.

Physical and Environmental Demands

Works in a clean well-lit environment with fluctuating temperatures in close proximity to others. Requires substantial periods of repetitive work utilizing a computer, headset, monitor, keyboard, and mouse. Requires walking and standing; requires frequent sitting more than 75% of the workday; requires the ability to negotiate stairs; requires visual, hearing acuity and manual dexterity to operate equipment.