Revenue Cycle Director

6 days ago

Santa Rosa, California, United States Santa Rosa Community Health Full time
Job Title: Director of Revenue Cycle

Join Santa Rosa Community Health as a Director of Revenue Cycle, a key role in overseeing the billing unit and making day-to-day decisions to ensure compliance with regulatory mandates. As a member of our team, you will be responsible for understanding billing policies and procedures, assisting in following up on insurance, Medi-Cal, and Medicare claims, and staying updated on all claims and their related AR statuses and issues.

Key Responsibilities:
  • Provide billing support to Billing Leads and billing team members when unavailable.
  • Oversee Billing staff activities, including work allocation and being available for staff needs.
  • Plan, manage, and coordinate with management team as it relates to billing and collections work loading and productivity tracking.
  • Assist in the follow-up of claims and obtainment of statuses using payor outreach, clearinghouse, and EPIC.
  • Understand and remain updated with current coding and billing regulations and compliance requirements.
  • Motivate employees to achieve peak productivity and performance.
  • Assist, resolve, and report any problems to the Director of Revenue Cycle regarding the day-to-day operations within the department.
  • Support front-end billing team with payer and customer-related questions and issues.
  • Perform quality reviews assessments to ensure employees meet departmental expectations and adhere to quality assurance guidelines.
  • Provide performance coaching and constructive performance feedback to Billing and Payment Posters.
  • Identify training opportunities through quality assurance reviews and prepare training materials for ongoing training resources.
  • Work closely with the Billing Data Management team to continuously monitor and improve billing system rules and setup for clean claim submissions.
  • Represent the Billing Department and interface with other departments as needed to respond to and resolve issues in the absence of the Director of Revenue Cycle.
  • Identify required missing billing information and assign appropriate attention level.
  • Verify and troubleshoot insurance eligibility and patient demographics.
  • Identify system issues and trends - report findings to the appropriate party.
  • High level of Customer Service, internal and external communication.
  • Maintain accuracy by following policies and procedures, reporting needed changes.
  • Maintain customer confidence and protect data by following HIPAA compliant regulations.
  • Assist with cross-training of other team members.
Requirements:
  • Medical Billing Certificate
  • Associate degree or equivalent experience
  • FQHC experience or 5 years of experience in healthcare
  • Capable of adapting to multiple applications of software
  • Knowledge of reimbursement processes, billing, and accounts receivable
  • Solid computer skills with emphasis on MS Office products
  • Must be comfortable working in a close-knit, team environment where attitude and work ethics are a priority
  • Excellent written and verbal communication skills
Preferred Qualifications:
  • FQHC experience
  • Experience successfully handling claims
  • Experience with Epic and E-Clinical Works
  • At least one-year related experience or equivalent
Physical Requirements:
  • Use standard office equipment and access, input, and retrieve information from a computer
  • Use computer keyboard with manual and finger dexterity and wrist-finger speed sufficient to perform repetitive actions efficiently for extended periods of time
  • Communicate effectively in person or via telephone in a manner that can be understood by those with whom the person is speaking, including a diverse population
  • Give and follow verbal and written instructions with attention to detail and accuracy
  • Perform complex mental functions; collect, interpret, and/or analyze complex data and information

Santa Rosa Community Health is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding, and related medical conditions), and sexual orientation.

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