Revenue Cycle Director

Job Description

Job Description

As a Revenue Cycle Director, you will serve as the primary lead for PHC’s billing and collections processes to increase cash flow and reduce patient accounts receivable.

The Revenue Cycle Director works collaboratively with the Patient Services Director to lead PHC’s revenue cycle. This position serves as the liaison between PHC’s Patient Services department, internal billing staff, and outsourced billing services in order to ensure an effective and efficient revenue cycle.

Supervises the internal billing team to ensure compliance with payer, accreditation, regulatory, state and federal rules and regulations as well as organizational policies and procedures.

Demonstrates PHC iCare values in daily work.

What's Great About this Position?

Earn 5 weeks of PTO throughout your first year of employment and enjoy paid holidays as well.

Continue to develop your skills and grow your career through PHC’s training opportunities including : PHC University, Emerging Leaders, and medical and dental assistant training programs.

What You Will Do

Serves as the primary liaison between PHC’s Patient Services department, billing staff, clinicians and clinics, and the outsourced billing team to ensure an effective and efficient revenue cycle for PHC.

Identifies negative Revenue Cycle trends, performs root-cause analysis, and develops resolution plans collaboratively with the billing team, health IT team, external partners (including, but not limited to, outsourced billing companies and EMR providers), and the Patient Services Director.

Develop and track agreed upon Revenue Cycle Metrics. Identify negative Revenue Cycle trends, perform root-cause analysis and develop resolution plans collaboratively with the billing team, Health IT team, vendors, and Patient Services Director.

Responsible for developing and tracking progress metrics for PHC assigned work queues. Ensures timely resolution of work queue items assigned to PHC as part of the billing arrangement by assigning responsibly to team members and monitoring follow-up.

Responsible for evaluation of outsourced team billing performance and intervening when issues arise to ensure that goals are achieved.

Responsible for working with payers and other outside entities to resolve recurring issues that cause denials, slow payment, or non-payment of claims.

Ensures compliance with established goals for billing, including the timely submission of all clinic charges and daily editing, ensuring appropriate coding, pay codes, etc.

Ensures compliance with all state and federal patient financial service requirements including, but not limited to, patient-rights, confidentiality, and third-party billing.

Oversees the response to inquiries on accounts by patients or third-party payors. Ensures incoming correspondence, including mailed denials, are assigned to appropriate staff within 48 hours of receipt.

Oversees day-to-day functions of the billing team including, but not limited to, claims review, timely claims submissions, payment posting and collections, etc.

Provides ongoing feedback and coaching to optimize engagement and productivity within the billing team. Establishes clear expectations for staff;

provides feedback on performance against expectations. Plans and implements interventions to ensure targets are achieved.

Hires, trains, addresses employee relations concerns, and evaluates assigned staff. Identifies emerging leaders and provides leadership development opportunities.

Assists in the development and maintenance of written policies, procedures and billing manual in relation to EMR functionality.

Maximizes use of EMR system, including building reports or dashboards for monitoring performance, or training staff on efficient use of system features.

Serves as a resource for PHC staff on billing processes and procedures.

Oversees month end activities, ensuring timely completion and that Revenue Cycle staff is up to date on month end work. Work directly with the internal and external billing team to effectively maintain billing denials at an acceptable level through audit and / or group and individual training.

Maintains compliance with PHC policies and procedures, with payers, and with external regulatory bodies such as but not limited to Joint Commission, HCFA, and BPHC.

Ensures Billing staff remains up do date on all regulatory or carrier rule changes, including maintaining a working knowledge of health information management issues such as HIPAA, compliance, and health information regulations.

Qualifications You Need to Bring

Required :

Associates degree in health information or related field or equivalent combination of education and

experience

A minimum of 5 years’ experience in a healthcare revenue cycle position.

A minimum of 2 years’ leadership or supervisory experience.

Experience working with financial systems.

Experience with electronic medical / dental records.

Proven ability to develop, analyze, implement and monitor productivity levels and quality-improvement

strategies.

Proven ability to identity missed opportunities, remove barriers and develop solutions to complex problems.

Ability to communicate effectively with leadership, providers and peers.

Leadership and supervisory skills with ability to coach, provide effective feedback and foster team

engagement.

Advanced computer skills with proficiency using Microsoft Office software and other database programs and

systems.

Detail oriented with high degree of accuracy.

Excellent written and verbal communication skills.

Organization, prioritization and time management skills with ability to work under minimal supervision.

Ability to establish and maintain effective working relationships.

Ability to work collaboratively with internal and external partners.

Preferred :

Bachelor’s Degree in health information or related field

A minimum of 10 years’ experience in a healthcare revenue cycle position.

Professional coding certification.

Bilingual, verbal and written language proficiency.

Community Health Center experience

Inpatient billing experience preferred

We Take Care of Our People

Your experience and skills determine your base pay. The hiring range for this position is typically $70,400 - $88,000 annually.

Candidates with extensive work experience related to this position may be considered for additional compensation up to the pay grade maximum of $105,600 annually.

PHC also offers a comprehensive benefits package, including :

Generous PTO accrual (equal to 5 weeks at end of 1st year) plus paid holidays

License / certification fee reimbursement

Paid time off for continuing education & continuing education reimbursement

Tuition reimbursement program

401k with company match

Medical insurance - PHC Pays, on average, 80% of medical premiums for all plan types (employee, employee + family, etc.)

Dental insurance

Vision insurance

Life & disability insurance

Flexible spending & health savings accounts

Supplemental accident & critical illness insurance

Discounts on pet insurance

Visit https : / / phciowa.org / careers for a summary of PHC’s benefits.

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