Quality Director

Quality Director - Revenue Cycle Management (RCM)

Requirements:

• Background in Revenue Cycle Management (RCM) within Healthcare, including Prior Authorization and Reverification.
• Minimum of 10 years of experience.
• Ability to start immediately or as soon as possible.

Role Overview:

A Quality Director for Revenue Cycle Management (RCM) ensures adherence to industry standards, regulatory compliance, and enhances patient care. Key responsibilities include:

1. Developing and enforcing quality standards through establishing policies and procedures.
2. Conducting audits and ensuring compliance with regulations such as HIPAA and OIG.
3. Managing risks by identifying and mitigating revenue cycle issues.
4. Optimizing workflows and processes for improved efficiency.
5. Providing staff training and guidance.
6. Monitoring key performance indicators (KPIs) and preparing reports.
7. Ensuring a high level of patient satisfaction.

Required Skills:

• Healthcare industry expertise.
• In-depth RCM knowledge.
• Leadership and excellent communication skills.
• Analytical and problem-solving abilities.
• Project management skills.
• Knowledge of regulatory compliance (HIPAA, OIG).

Certifications:

• CMC (Certified Medical Coder)
• CPC (Certified Professional Coder)
• CPHQ (Certified Professional in Healthcare Quality)
• CQM (Certified Quality Manager)