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Dir, Revenue Cycle Management
2 weeks ago
As a Director of Revenue Cycle Management, you will provide strategic guidance at the Director level in all areas of the Agency's Revenue Cycle, including Electronic Health Record, Financial Counseling, Data Analysis, Insurance Verification and Provider Credentialing, Revenue Integrity, Coding, Client Accounting, and Collections. You will report to the Chief Financial Officer and work onsite.
Responsibilities:
- Responsible for accurate and complete monthly billing to Insurance companies (including Medicare and Medicaid), clients, customers, funding sources, and grantors for all programs of Northern Rivers and Affiliated Agencies.
- Train, cross-train, oversee, coach, and complete disciplinary actions for department staff.
- Liaison to contracted billing company
- Prepare and manage communications with all partners to ensure revenue cycle optimization, which may be confidential and sensitive.
- Maintain accurate, complete, and appropriate procedure manuals for each monthly billing to customers, funding sources, and grantors for all programs of Northern Rivers and Affiliated Agencies.
- Assess operational workflows and compliance issues and work with team to improve and strengthen operations and compliance on routine basis.
- Prepare data analysis, identify trends, collaborate with program leadership for budgeting, forecasting an operational improvement planning.
- Ensure eligibility verification for client in all applicable programs or coordination of such with program eligibility teams
- Ensure provider credentialing and rostering with facility and professional insurance networks, Medicaid and Medicare as applicable.
- Oversee claim review audit with consultants and internal compliance and audit teams.
- Review and coordinate OMIG overpayments, full-disclosure and abbreviated self-disclosures.
- Monitor of Aged Accounts Receivable and cash collection of outstanding account balances owed to Northern Rivers and Affiliated Companies on an ongoing basis
- Responsible for review of balances in Deferred Revenue and Unearned Income requiring periodic adjustment to or clearing out of such balances, and also the periodic review and write off of outstanding accounts deemed uncollectible
- Maintain knowledge of current federal, state, and local government funding and billing regulations, and stays informed about changes to funding mechanisms.
- Provide exceptional customer service to all organizational customers, internal and external
Requirements and Education:
- High School Diploma with minimum 10 years experience or Bachelor's Degree with minimum 7 years experience as leader of Revenue Cycle Operations required
- Experience with commercial facility and professional claiming required
- Experience with Medicare and Medicaid required
- Experience with Article 31 clinics preferred
Benefits
- Health care package: medical, dental, and vision
- Tuition reimbursement
- Paid time off
- Holiday Pay
- 401 (K) plan
- Life Insurance
- Loan repayment assistance
- Free training/CEU opportunities
At Northern Rivers Family of Services, we work together to make a difference in our client's lives. Northern Rivers empowers children, adults, and families to change their lives and build stronger communities.
Northern Rivers Family of Services is an Equal Opportunity Employer. We hire great people from a variety of backgrounds, not because it is the right thing to do, but because it makes us stronger All applicants will be considered for employment without attention to race, color, religion, sex, orientation, gender identity, national origin, veteran or disability status, or any other characteristic protected under applicable law. We cherish the unique contributions of our diverse staff and are building a culture where everyone has the opportunity to do the meaningful work.
As a Director of Revenue Cycle Management, you will provide strategic guidance at the Director level in all areas of the Agency's Revenue Cycle, including Electronic Health Record, Financial Counseling, Data Analysis, Insurance Verification and Provider Credentialing, Revenue Integrity, Coding, Client Accounting, and Collections. You will report to the Chief Financial Officer and work onsite.
Responsibilities:
- Responsible for accurate and complete monthly billing to Insurance companies (including Medicare and Medicaid), clients, customers, funding sources, and grantors for all programs of Northern Rivers and Affiliated Agencies.
- Train, cross-train, oversee, coach, and complete disciplinary actions for department staff.
- Liaison to contracted billing company
- Prepare and manage communications with all partners to ensure revenue cycle optimization, which may be confidential and sensitive.
- Maintain accurate, complete, and appropriate procedure manuals for each monthly billing to customers, funding sources, and grantors for all programs of Northern Rivers and Affiliated Agencies.
- Assess operational workflows and compliance issues and work with team to improve and strengthen operations and compliance on routine basis.
- Prepare data analysis, identify trends, collaborate with program leadership for budgeting, forecasting an operational improvement planning.
- Ensure eligibility verification for client in all applicable programs or coordination of such with program eligibility teams
- Ensure provider credentialing and rostering with facility and professional insurance networks, Medicaid and Medicare as applicable.
- Oversee claim review audit with consultants and internal compliance and audit teams.
- Review and coordinate OMIG overpayments, full-disclosure and abbreviated self-disclosures.
- Monitor of Aged Accounts Receivable and cash collection of outstanding account balances owed to Northern Rivers and Affiliated Companies on an ongoing basis
- Responsible for review of balances in Deferred Revenue and Unearned Income requiring periodic adjustment to or clearing out of such balances, and also the periodic review and write off of outstanding accounts deemed uncollectible
- Maintain knowledge of current federal, state, and local government funding and billing regulations, and stays informed about changes to funding mechanisms.
- Provide exceptional customer service to all organizational customers, internal and external
Requirements and Education:
- High School Diploma with minimum 10 years experience or Bachelor's Degree with minimum 7 years experience as leader of Revenue Cycle Operations required
- Experience with commercial facility and professional claiming required
- Experience with Medicare and Medicaid required
- Experience with Article 31 clinics preferred
Benefits
- Health care package: medical, dental, and vision
- Tuition reimbursement
- Paid time off
- Holiday Pay
- 401 (K) plan
- Life Insurance
- Loan repayment assistance
- Free training/CEU opportunities
At Northern Rivers Family of Services, we work together to make a difference in our client's lives. Northern Rivers empowers children, adults, and families to change their lives and build stronger communities.
Northern Rivers Family of Services is an Equal Opportunity Employer. We hire great people from a variety of backgrounds, not because it is the right thing to do, but because it makes us stronger All applicants will be considered for employment without attention to race, color, religion, sex, orientation, gender identity, national origin, veteran or disability status, or any other characteristic protected under applicable law. We cherish the unique contributions of our diverse staff and are building a culture where everyone has the opportunity to do the meaningful work.
