The Director of Revenue Cycle is responsible for the over all direction and coordination of RCM operations including the ASC and all out patient clinics. RCM includes registration, pre-case estimates, charge capture and CDI, billing and collections, data processing, cash management, revenue integrity, customer service, patient billing, Physician credentialing and general oversight.
- Directs, trains and mentors RCM team as well as support staff who directly impact RCM outcomes.
- Designs and drives process improvement throughout the Revenue Cycle. Collaborates with team and tracks process improvement initiatives and overall improvements.
- Supports operational leaders by providing standardized reporting, analytics and dashboards highlighting key areas for improvement. Provides monthly reporting for Board meetings.
- Works with RCM staff to solve difficult accounts and associated business office problems including claims processing and billing issues. Review and address escalated patient complaints and audit problem accounts.
- Develops necessary reporting to manage team effectively. Regular monitoring of dashboards to include collection rates, aged A/R, denial trending, claim edits, productivity, underpayments etc.
- Establish a proactive denial management process to monitor and prevent denials. Works with various departments to ensure education, compliance and acceptance of processes to prevent unnecessary denials. Development of tools, claim edits and QA for staff.
- Leads efforts around RCM in developing new strategic business opportunities.
- Responsible for the maximization of revenue and cash flow while maintaining the highest levels of patient, physician and employee satisfaction and relations.
- Ability to effectively communicate regulatory changes to providers and to educate on coding compliance. Performs audits of provider billing for proper service levels, ensuring documentation is appropriate and provides feedback and education.
- Develops policy and procedure to maximize technology via EMR and PM system. Is expert in utilization of practice software and workflows.
- Responsible for HR management of RCM staff to include hiring, training, performance evaluations, merit increase, promotions and disciplinary actions.
- Adheres to HIPAA regulations
Required Skills and Experience
- A minimum of seven years medical billing experience, with at least four years of which is in a strong supervisory role. Demonstrated operational knowledge of Healthcare Revenue Cycle. Physician practice experience within an ASC is highly preferred.
- BS, BA or equivalent combination of education and experience required.
- Experience working with an electronic medical record and other information technology and systems that support financial integration across the organization is required.
- Strong physician relation skills, innovative solutions thinker, self starter.
Northwest Orthopaedic Specialists offers competitive compensation, great health benefits, 401(k), profit sharing, continuing education and many other useful supplemental benefits.