Revenue Cycle Director

5 days ago


Mankato, Minnesota, United States Open Door Health Center Full time
Job Summary

The Revenue Cycle Manager is responsible for leading the organization's revenue cycle process. This includes, but is not limited to, monitoring and enforcing the billing teams workflow, providing education and training to manager and staff related to revenue cycle. The Revenue Cycle Manager manages all functions of the ODHC billing and revenue cycle to maximize cash flow while maintaining and improving internal and external customer relations.

Key Responsibilities
  • Revenue Cycle Process Management: Manage daily operating functions of revenue cycle process and billing staff.
  • Policy and Procedure Development: Assists with developing and enforcing revenue cycle policies and procedures.
  • Communication and Strategy: Communicates effective strategies for improving revenue cycle process to Clinic Managers, staff and billing company on a regular basis.
  • Process Improvement: Takes action towards continuous improvement and innovative use of billing software, including more automation.
  • PM System Management: Overall management of the PM system for efficient and functional use including but not limited to enforcing protocols and procedures, updates, reporting management, software upgrades.
  • Automation and Reporting: Proactively develop automation for billing and reporting functions.
  • Financial Reporting: Meets deadlines for month end close and reporting; produces accurate monthly revenue cycle reporting.
  • Regulatory Compliance: Proactively studies, recommends and leads implementation of revenue cycle improvements.
  • Compliance and Licensing: Manages compliance with Federal, State and payer rules and regulations and reporting, including, but not limited to UDS reporting.
  • Provider and Staff Management: Ensures that start up offices are properly licensed and complaint for operation. Ensures that current office sites are current concerning state and federal licensure.
  • Credentialing and Re-Credentialing: Manages provider and staff organization and payer credentialing process.
  • Denial and Billing Error Management: Identifies denial/billing error trends through management of Days in AR and other billing metrics and communicates these to the CFO.
  • Customer Service: Proactively ensure superior customer service to internal and external customers according to standards set by Open Door Health Center.
  • Training and Development: Develops and leads ongoing revenue cycle training for all staff
  • Financial Planning and Budgeting: Provides projections and reports as required, for development and management of budget.
  • Guideline Updates: Update/keep up to date current CPT, ICD-10, and HCPCS guidelines.
  • Department Performance Monitoring: Monitors timeliness and effectiveness of department activities, ensuring that outstanding patient accounts and accounts receivables is not more than the agreed upon limit and that bad debt is within budgeted target.
  • Status Reporting: Complies and prepares various status reports for management in order to analyze trends and make recommendations.
  • Program Development: Work collaboratively with leadership to implement new programs and services to meet identified populations needs.
  • Credentialing Support: Assist Human Resources Department with Credentialing and Re-Credentialing of all licensed staff
  • Provider Grid Management: Maintain internal provider grid to ensure all information is accurate and login are available.
  • Provider Profile Management: Maintain accurate and up to date provider profiles on CAQH and all applicable databases.
  • Revalidation Requests: Complete revalidation requests issued by government payers.
Requirements
  • Education: BA/BS degree or equivalent in business, accounting, or related field.
  • Experience: A minimum of 3 years' experience in healthcare management such as but not limited to clinic management, patient management, accounts receivables and payables.
  • Skills and Qualifications: Strong background in financial management and knowledgeable of federal and state laws and requirements relating to healthcare management. Strong managerial competencies in the areas of leadership and team development, managerial coaching and mentoring, and situational assessment skills and with proven track records in building and developing high performing teams.
  • Language Skills: Bilingual skills are a plus.


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