Director of Revenue Cycle Management - USA Clinics Group

The Director of Revenue Cycle Management (RCM), reporting to the Senior VP of Revenue Cycle Management, acts as a strategic leader for all revenue cycle functions and activities with the goal of optimizing revenue. This position is responsible for ensuring compliance with third party payor requirements as well as all applicable state/federal laws and regulations.

The Director of RCM is accountable for ensuring the coordination of operations, procedures, and best practices for billing, collections and follow up, and denials management for the assigned practices and specialty service lines. Specific functional areas of oversight include payment posting; EDI claims and statement submission; AR follow up for insurance and self-pay; and collections workflows. The director works closely with registration, coding and clinical areas to optimize revenue collection while ensuring a seamless billing experience for patients.

Only candidates who can reliably commute to the position's location in Northbrook, IL will be considered.

Responsibilities

• Directs all activities for assigned revenue cycle areas, ensuring optimal revenue collection and patient satisfaction with the billing experience, and ensuring compliance
• Provides direction on the incorporation of new providers and client practices into existing patient accounts workflows, with a focus on optimizing AR collection for the group

• Works closely with IT department to implement RPA (Robotic Process Automation) to resolve barriers impacting optimal collections
• Acts as a liaison to clinical and non-clinical departments to ensure that new initiatives and contracts are accurately implemented, monitored, and followed
• Develops key performance indicators, dashboards, and system improvements to improve visibility and efficiency of the revenue cycle process
• Works closely with SVP to develop and maintain appropriate internal controls for internal and external auditor or customers.
• Analyzes accounts receivable and denial reports to identify and develop system and IT improvements

• Develops staff that can analyze and recommend ongoing improvements to processes, procedures, systems, and reports
• Ensures compliance with USAVC policies and procedures, health plan requirements, and federal and state laws and regulations
• Performs additional duties as assigned

Requirements

• Bachelor's Degree required; Masters preferred in a related field
• Minimum of 12 years of progressive responsibility in a revenue cycle department, required
• Minimum of 7 years prior revenue cycle experience in a physician-driven Patient Accounts department required
• Thorough understanding of physician billing practices and procedures, including knowledge of state, local and federal laws, required
• Experience with practice management systems required
• Strong knowledge of Microsoft Excel (VLOOKUP and Pivot Tables) required
• Strong knowledge of reimbursement rules and methodologies for both physician and ambulatory surgery billing, preferred
• Prior experience leading various areas of revenue cycle (billing, collections, denials etc.) with proven success in achieving revenue cycle efficiencies and improving cash flow
• Strong people management experience

Benefits

• Health
• Dental
• Vision
• 401K & Match
• PTO