Revenue Cycle Director

Hoskinson Health & Wellness Clinic is a pioneering healthcare organization dedicated to providing comprehensive care to the community. Our mission is to empower patients to live better, healthier lives through integrated regenerative and longevity philosophies.

The Revenue Cycle Manager is a key role responsible for overseeing and optimizing all aspects of the revenue cycle process. This includes managing staff, ensuring compliance with regulations, and implementing strategies to enhance revenue flow and operational efficiency.

• Oversee the entire revenue cycle, including billing, coding, collections, and denial management.
• Manage relationships with external vendors for practice management software and clearinghouse vendors.
• Communicate effectively with various payers.
• Manage, develop, and mentor revenue department staff, including billers and coders.
• Oversee the admission process and manage the admissions team.
• Responsible for managing and maintaining billing and practice management software platforms.
• Provide ongoing education for clinical, billing, and coding staff on coding trends.
• Develop, evaluate, implement, and revise policies and procedures related to billing, coding, reimbursement activities, and improvement strategies.
• Reconcile all receivables and revenue reports and work closely with the finance department in the development of the monthly financial statements.
• Manage and update the charge master based on the current CMS fee schedule and negotiated contracts.
• Conduct monthly analysis of Medicare/Medicaid/Third Party Payers.
• Oversee the processing of credentialing and provider enrollment applications, initial, and re-enrollment status with all Medicaid, Medicare, and Commercial Payors.
• Responsible for the generation and management of revenue, admissions, and credentialing metric reports.
• Review and resolve issues related to claim generation and rejected/denied billings.
• Commit to maintaining the highest level of business and patient confidentiality, adhering to all HIPAA and security guidelines when accessing and sharing patient information.
• Stay up-to-date on all reimbursement billing procedures of third-party and private insurance payers and government regulations.
• Maintain appropriate internal controls over accounts receivable, RCM process.
• Monitor accounts sent for collection and reimbursements from insurance companies and other third-party payers.
• Reviews, monitors, and evaluates third-party reimbursement and researches variances.
• Participate in the development of coding and billing strategies, evaluating process relative to revenue cycle, and making recommendations while ensuring compliance with any relevant rules or regulations (including HIPAA, Medicaid, Medicare, and specific 3rd Party Payors).

• Bachelor's degree in Finance, Healthcare Administration, Business Administration, or a related field; Master's degree preferred.
• 5+ years of experience in revenue cycle management, preferably in a healthcare setting.
• Proven experience in managing teams and driving process improvements.

• Strong knowledge of healthcare billing and coding regulations (e.g., ICD, CPT).
• Proficient in revenue cycle management software and electronic health record (EHR) systems.
• Excellent analytical and problem-solving skills.
• Detail-oriented with strong organizational abilities.
• Ability to work collaboratively with diverse teams and stakeholders.
• Strong leadership and communication skills.

• Health Insurance: Company pays 100% of your health insurance premiums, which includes a low-deductible health plan through Cigna, Vision, and Dental.
• Additional Insurance: $50 employer monthly allotment for Disability, Life insurances, Cancer coverage, Accident policies, and more through a supplemental company.
• Retirement: Up to 8% match for retirement, no waiting period.
• Vacation & leave: Generous vacation and sick leave with accrual and carry-over opportunities.
• Continuing or Additional Education: HH&WC will assist in the professional development of all employees with HR approval.