Director of Revenue Cycle

The Director of Revenue Cycle is responsible for overseeing the entire revenue cycle process within the organization, ensuring efficiency, compliance, and optimization to maximize cash flow. This role includes serving as the OMIG Compliance Officer for Medicaid, tasked with maintaining regulatory compliance and managing audits. The Director will report directly to the Chief Operation Officer and collaborate closely with various departments to achieve financial objectives. Essential Duties and Responsibilities - Oversee the workflow of the revenue cycle team, ensuring clear accountability and performance standards. - Supervise billing, collections, and payment processes to ensure timely submission of claims and effective management of accounts receivable. - Identify and implement process improvements to enhance efficiency and reduce revenue leakage throughout the revenue cycle. - Serve as the OMIG Compliance Officer for Medicaid, ensuring adherence to all relevant regulations and payer guidelines. Conduct regular audits to identify discrepancies and maintain compliance. - Manage medical record and insurance audits, ensuring that services are accurately documented and billed. Collaborate with clinical teams to resolve documentation issues. - Analyze claim denials and develop strategies to prevent future occurrences. Work with relevant departments to address issues impacting revenue. - Foster relationships with finance, clinical, and operations teams to streamline processes from patient care to payment collection. - Prepare detailed reports on revenue cycle performance, trends, and forecasts to support strategic decision-making. - Stay up to date on payor policies and guidelines and help organization achieve compliance. - Mentor and develop revenue cycle staff, providing training and performance evaluations to promote a culture of accountability and continuous improvement. - Facilitate communication and collaboration across departments to ensure alignment with financial objectives. - Participates in and leads EOS meetings on a weekly basis. - Performs other duties as assigned. Qualifications Education and Experience - Bachelors degree in business, finance, healthcare administration, or a related field; masters preferred. - 7+ years of experience in revenue cycle management, with at least 3 years in a leadership role. - Strong understanding of healthcare billing practices, payer regulations, coding (CPT, ICD-10), and financial processes. Skills and Abilities - Excellent verbal and written communication skills. - Strong analytical and problem-solving abilities. - Proficiency in revenue cycle management software, electronic health records (EHR), and data analytics tools such as Power BI. - Leadership skills with a focus on team development and motivation. - Ability to prioritize tasks, delegate effectively, and maintain integrity and confidentiality.

Created: 2024-11-06