The Revenue Cycle Director will provide strong leadership, and directly manage all functions of the billing and collections staff (medical, behavioral health, and dental), and indirectly influence all functions that impact the revenue cycle. The RCD’s objective is to maximize cash flow while maintaining and improving interdepartmental collaboration and maintaining excellent payor, vendor, and patient relations. The RCD will contribute to the day-to-day operations of all issues related to the revenue cycle function, provide analysis, create written processes, and train others in implementing a cross-functional revenue cycle team.
- Provide leadership and direction of day-to-day operations while working closely and taking direction from the Controller.
- Direct and oversee the strategic function and processes for billing and revenue cycle.
- Provide leadership in the planning, development, and implementation of departmental objectives; develops specific goals and standards that directly support the company’s objectives.
- Assist in the preparation of the RCM budget with input from the leadership team; monitor expenditures with the finance management team.
- Monitor the financial performance of the department, control staffing needs, operations budget, and capital budget. Closely monitor variations in financial performance.
- Oversee regulatory compliance and contracts regarding insurance payers.
- Ensure adherence to and compliance of payer, government, and internal system regulatory policies as they relate to medical billing.
- Oversee the medical billing chart audit process
- Ensure all Company practices are in compliance with external regulatory agencies such as the Health Insurance Portability and Accountability Act (HIPAA), Medicare, Medicaid, and other third-party payers, and institutional policies.
- Manages staff relations including performance management, staff satisfaction, and conflict management.
- Establishes standards of quality, productivity, and performance. Provides ongoing feedback and direction to direct reports.
- Works collaboratively with our Providers and other departments.
- Recommends new approaches, policies, and procedures to influence continuous improvements in the department’s efficiency and services performed.
- Monitors change in the medical insurance industry and adjust procedures accordingly.
- Supervises, trains, and mentors assigned personnel. Evaluates performance and recommend pay increases, promotions, and disciplinary actions.
- Maintains knowledge of and complies with established policies and procedures.
- Attends required meetings and participates in committees as requested.
- Participates in professional development activities and maintains professional affiliations.
EDUCATION AND EXPERIENCE
- Bachelor’s degree in Accounting, Finance, Business Administration, or Healthcare Administration preferred; associate’s degree required.
- A Minimum of three years of medical billing and medical management experience required
- Two years of management/supervisory experience is required
- CPC and/or CPB or similar certification highly desired
- Advanced and current working knowledge of ICD-10, CPT, and HCPCS codes
- Current knowledge of insurance payer coding and reimbursement guidelines
- The ideal candidate will be proficient with eClinicalWorks
- Previous experience with a Federally Qualified Health Center (FQHC) is strongly preferred
- Sound knowledge of health insurance providers
- Proficient with Microsoft Office Suite specifically Excel, Word, and PowerPoint
SKILLS AND ABILITIES
- Demonstrates the ability to work in a high-pressure environment
- Strong active listening skills, attention to detail, and decision-making skills are required
- A pleasant, friendly attitude with the ability to adapt to change is essential
- Superior problem-solving abilities are required
- The ability to collaborate with all levels of leadership is essential
- Possess the ability to work with patients, clinical, non-clinical staff, and providers from a variety of backgrounds and lifestyles while maintaining a non-judgmental attitude.
- Possess excellent customer service skills and be well organized.
- Knowledge of industry policies, standards, regulations, and protocols.
- The ability to lead and grow a team
- Ability to communicate effectively utilizing both oral and written means.
- Ability to take initiative and handle various tasks simultaneously while working efficiently, effectively, and independently
- Must be comfortable working and making decisions independently
- Able to identify, initiate, implement, and manage business practices, policies, and processes
The typical work day is Monday-Friday; 8:00 AM to 5:00 PM.
CareSouth Carolina is committed to providing equal employment opportunities to all. We seek to have a diverse, inclusive workforce and encourage applications from all qualified individuals without regard to race, color, age, sex, gender identity or expression, sexual orientation, religion, marital status, citizenship, disability or veteran status.