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Director/Senior Director of Revenue Cycle Management

Company: Leading Healthcare Provider
Location: Raleigh
Posted on: February 23, 2021

Job Description:

Director of Revenue Cycle Management
*MUST BE IN COMMUTING DISTANCE TO RALEIGH-DURHAM*
Job Purpose: Lead the Revenue Cycle Department to generate the best possible financial outcome for the company at the lowest possible compliance risk through research, collaboration, execution and structured communication.
---Essential Duties and Responsibilities

  • Lead RCM strategic planning, strategy execution, and implementation of standardized processes and procedures to produce predictable high-quality financial outcomes.
  • Ensure scalable but nimble department structure that supports the organization's growth plan
  • Coach department managers on business plans, staffing, and decisions
  • Ensure compliance to each of the programs, as well as others to be identified:
  • Government and Commercial Payers Contracts
  • Accountable Care Organization agreements
  • Meaningful use and MIPS/MACRA
  • Coding standards as defined by AMA through CPT, ICD, and HCPCS
  • CPT Category II quality reporting
  • Ensure all RCM department tasks are completed with compliance to the Company and regulatory standards including, but not limited to:
  • Account Receivables
  • ERA, Manual Check, and Collection Agency Payment Postings
  • Statement Processing and Refunds
  • Medical Coding and Provider Training
  • Compile and review reports provided by department managers and develop action plans to address negative trends, as applicable
  • Support the Company's strategic execution of ACO agreements, as they relate to HCC/RAF, CPT Category II coding, and other coding deliverables
  • Compliance planning as it relates to government and private contracts, rules, and regulations, including development and application of compliance policy and procedure
  • Top level escalation support for both patient and payer billing issues
  • Interview, hire, and provide orientation to direct reports
  • Hold and attend regular meetings with providers, clinical, administrative, or managerial staff to share information and communicate on company issues, as needed
    QualificationsExperience, Education and Licensure:--- MHA or MBA, preferred--- Minimum 8-10 years of health care billing and/or coding management experience--- CPC Certification, preferred--- Knowledge of CPT, HCPCS, and ICD-10 coding
    Knowledge, Skills, and Abilities:--- Ability to read and interpret documents--- Ability to write reports, business correspondence, and procedure manuals--- Ability to effectively present information--- Ability to interact and communicate with a variety of people--- Ability to anticipate and react calmly to emergency situations--- Ability to work with mathematical concepts such as probability and statistical inference; ability to apply concepts such as fractions, percentages, ratios, and proportions to practical solutions--- Ability to define problems, collect data, establish facts, and draw valid conclusions--- Ability to make independent decisions and delegate responsibility and duties--- Ability to follow direction--- Proficient computer skills, including knowledge of Microsoft Office Suite, e-mail systems, and web-based programs--- Ability to handle multiple tasks simultaneously--- Excellent supervisory, managerial skills--- Excellent supervisory, managerial skills--- Excellent leadership qualities--- Knowledge and understanding of how for-profit medical practices run--- Working knowledge of accounting, including ledger, balance sheet, payroll, taxation, etc.

Keywords: Leading Healthcare Provider, Raleigh , Director/Senior Director of Revenue Cycle Management, Executive , Raleigh, North Carolina

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