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Head of Revenue Cycle Management

2 months ago

Leander, Texas, United States Gateway Community Health Center Full time
Job Overview

POSITION SUMMARY: The Director of Revenue Cycle Operations is accountable for overseeing the revenue cycle functions of the organization. This role necessitates collaboration and effective communication with various departments, operational leaders, clinical management, and external partners, including insurance representatives and revenue cycle vendors, to ensure the delivery of efficient and timely patient billing services.


REPORTING STRUCTURE: This position reports directly to the Chief Financial Officer.


TEAM MANAGEMENT: Supervises the Business Office Manager, Claims Auditor, and Business Office Clerks.


PHYSICAL REQUIREMENTS: This role requires prolonged periods of sitting and may involve lifting items up to 25 pounds. Proficiency in using office equipment such as computers, telephones, and copiers is essential.


KEY RESPONSIBILITIES:

  • Exhibits leadership and maintains frequent communication with senior management regarding complex information and negotiations.
  • Oversees daily operations of the business office, including registration, billing, reimbursement, accounts receivable management, compliance, and medical records.
  • Acts as the primary liaison with revenue cycle contractors to manage billing, coding, credentialing, denial, and appeal processes.
  • Ensures that services under supervision are delivered in a professional and high-quality manner.
  • Guarantees compliance of the business office with organizational and strategic planning objectives.
  • Collaborates with the CFO to develop, implement, and assess policies, procedures, and performance metrics for business office functions.
  • Ensures adequate staffing and timely operations in all supervised areas.
  • Addresses patient concerns regarding services provided.
  • Works with the Business Office Manager to design and execute CPRIM (Compliance, Performance Improvement, and Risk Management) audits.
  • Evaluates business office operations and formulates corrective action plans as necessary.
  • Assists the CFO in coordinating inter-departmental services and ensuring adherence to policies and procedures.
  • Prepares monthly reports for the CFO, including management and UDS reports.
  • Conducts audits in the business office for compliance on a monthly, quarterly, and yearly basis.
  • Facilitates training for new staff and ongoing training sessions to enhance business office operations and ensure compliance.
  • Stays informed about changes in third-party billing and ensures staff are updated.
  • Maintains records of employee attendance and leave balances.
  • Prepares reports and training materials as needed by management.
  • Develops job descriptions for direct reports.
  • Evaluates performance of supervised employees.
  • Identifies continuing education needs for staff.
  • Conducts interviews for vacant positions within the team.
  • Assists staff with minor technical issues and coordinates with IT for more significant problems.
  • Monitors daily attendance of business office personnel.
  • Performs additional duties as assigned.

QUALIFICATIONS:

  • Bachelor's degree in business administration or a related field.
  • Equivalent experience may substitute for educational requirements, with a minimum of five years in a management role within a similar environment.
  • Bilingual proficiency in English and Spanish is preferred.

SKILLS AND COMPETENCIES:

  • Comprehensive understanding of patient financial service principles related to billing and collections.
  • Strong analytical and communication abilities.
  • Proven leadership capabilities.
  • Familiarity with corporate, federal, state, and regulatory requirements affecting fiscal services.
  • Ability to exercise sound judgment.
  • Effective verbal and written communication skills.
  • Demonstrated management skills and knowledge of supervisory techniques.
  • Proficient in Microsoft Office applications, particularly Word and Excel.
  • Commitment to maintaining confidentiality.
  • Exceptional organizational skills.
  • Willingness to travel to various locations as needed.
  • Possession of a valid driver's license and insurance coverage.