Director of Revenue Cycle - Peoplepack LLC

We are recruiting for a Director of Revenue Cycle for a Denver-based not-for-profit hospice, home health and palliative care provider that serve patients and communicates across Colorado. The Director of Revenue Cycle is responsible for the oversight of all claim development, claim submission, denial investigation, and collections / follow-up activity related to all company services and payer sources. This person also monitors accounts to effectively reduce Days Sales Outstanding and improve cash flow, and provides linkage to other department personnel to correct and resubmit billing, and if necessary, makes recommendations to leadership to write-off account balances deemed uncollectable to ensure the ability to successfully bill and collect for services rendered.

Key responsibilities include:

• Leads the overall development, interpretation, coordination, and administration of system policies governing all aspects of the revenue cycle.
• Drives continuous revenue cycle process improvement universally and largely standardized and aligned with industry best practice standards to achieve data-driven results.
• Develops, implements, and maintains strategies by working with internal and cross-functional partners to achieve optimal revenue cycle performance.
• Leads the billing team and ensures the correct NPI/taxonomy/billing code configuration is accurate.
• Plans and evaluates the day-to-day workflow of the billing office; sets priorities and goals for billing manager and staff.
• Performs regular accounts receivable aging reviews with billing team to monitor balances that are approaching unacceptable time frames or dollar amounts.
• Reviews claims for collectability, recommends claims for write-off, and calculates the Allowance for Bad Debt on a monthly basis.
• Works closely with key stakeholders in operations including admissions, clinical operations and HIM to ensure efficient operations and streamline revenue cycle processes.
• Reports key Performance Indicators (KPIs) on a monthly basis. Continuously monitors the regulatory environments to ensure that payors evolving reimbursement structures, documentation requirements, and other requirements are evaluated and necessary changes in policies and procedures (and systems) are completed.
• Initiates development of new approaches to streamline existing processes, reorganize work, implement new technologies, and improve resource utilization as RCM links to the organization.
• Ensures that billing rates are updated per both Medicare and Medicaid guidelines, and all commercial contracts, coordinating with other department leaders on maintenance.
• Recruits, trains, and mentors team members to cultivate high performance. Ensures cross-training and backup for each significant payer and critical tasks.
• Participates in continuing education and professional development. Participates in organization and community events and professional associations as required.
• Maximizes customer relationships and directly interfaces on collection matters and dispute resolution.
• Ensures that timely and accurate payment and account standing information is provided to leadership and management as needed and/or appropriate.
• Maintains a working knowledge of all revenue cycle management computer systems; works with internal IT staff and external software vendor to stay current with changes in technology; ensures all payer information is set up correctly.
• Participates in the monthly financial closing process to accurately capture Electronic Medical Record (EMR) totals for entry into the financial General Ledger (GL) system.

Qualifications:

• Minimum Education: Bachelor’s degree required; master’s degree preferred.
• Minimum Experience: Five to seven (5-7) years of finance, billing and/or revenue cycle experience with increasing responsibilities required; with at least three years of managerial experience.

If this sounds like you, let's connect!

www.peoplepacktalent.com