Director of Revenue Cycle Management

City of Lincoln; Eugene (OR); On-site; USD 120,000 - 180,000; Full time

Job summary

Slocum Orthopedics is seeking a Director of Revenue Cycle Management to oversee all RCM processes, including coding, eligibility, prior authorization, posting, and collections. The role leads cross-functional teams, develops dashboards, and guides strategic initiatives to improve cash flow and profitability.

The ideal candidate has a healthcare revenue cycle leadership background, strong financial acumen, and experience with Medicare/Medicaid/VA/government plans.

Qualifications

• B.A. in health care administration, business, or related field; Master’s degree preferred.
• 5-7 years Healthcare Revenue Cycle Management experience overseeing a healthcare revenue cycle and associated staff
• Strong background in financial management and knowledge of federal and state laws related to healthcare management.
• Prior experience leading revenue cycle areas (billing, collections, denials) with proven cash-flow improvements.
• Extensive experience billing Medicare, Medicaid, VA/Government plans, and Commercial insurance.
• Working knowledge of computer software and hardware, preferably data processing in a medical environment.

Responsibilities

• Oversees all Revenue Cycle functions: coding, eligibility, prior-authorization, posting, AR follow up.
• Plans and implements programs to improve revenue cycle profitability and efficiency.
• Develops and maintains dashboards and reports including KPIs and executive dashboards.
• Provides data-driven insights to drive efficiency and best practices in revenue cycle operations.
• Leads staffing, budgeting, and cross-functional collaboration with Operations, Finance, HR, IT, and Compliance.
• Develops internal controls and ensures contracts are implemented correctly.

Skills

Leadership

Data analysis

Staff development

Budgeting

Cross-functional collaboration

Process improvement

Education

Bachelor's degree in healthcare administration/business

Master’s degree preferred

5-7 years revenue cycle experience

Job description

• Job Category 11
• Employee Type Exempt
• Required Degree Masters
• Manage Others Yes

Description

• Oversees all functions of the Revenue Cycle process, including coding, eligibility, prior-authorization, payment posting, patient account representatives, charge entry, EDI/claim submission/claims rejects, A/R follow up, patient statements, and external collections activities.
• Plans, develops, and implements programs, projects, strategies, processes, and technology to continuously improve and manage the revenue cycle and increase profitability.
• Collects, organizes, analyzes, and disseminates significant amounts of information from various data sources with attention to detail and accuracy, including timeliness.
• Develops and maintains department dashboards and distributes reports to the appropriate audience. This includes departmental KPIs and reports, executive dashboards, staff productivity, and quality reports, etc.
• Provides data driven insights and actionable information to drive improvement, increase efficiency, and implement best practices in revenue cycle operations. Monitors key performance indicators and escalates issues to senior management as appropriate
• Reports on daily operational statistics as requested by leadership, key findings, insights and recommendations to respective counterparts.
• Analyzes data for insights into claims management, and for special prevention and denials management projects. This includes identifying denial trends by root cause, Payor-related issues, physician trends, etc.
• Develops and ensures implementation of policies, guidelines, and implementation procedures; and ensures goals and objectives are properly defined and clearly established.
• 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
• Motivates and leads high-performing teams; attracts, recruits and retains required members as needed. Hires and trains all revenue cycle personnel in coordinating with subordinate supervisors.
• Develops staff that can analyze and recommend ongoing improvements to processes, procedures, systems and reports
• Determines and maintains appropriate staffing metrics and measurements based on client and business demands.
• Works closely with leaders in the areas of Operations, Finance, Human Resources, Information Systems, and Compliance to achieve business objectives and implement organizational strategy.
• Develops and manages an annual budget.
• Works with the CFO and company leaders to develop and implement the revenue cycle strategy.
• Works closely with IT department to optimize the use of technology to automate revenue cycle functions
• Analyzes and resolves problems that affect the revenue cycle, both inside and outside of the Business Office.
• Acts as a liaison to clinical and non-clinical departments to ensure that new initiatives and contracts are accurately implemented, monitored and followed
• Develops and maintains appropriate internal controls in the Business Office and Coding departments.
• Other duties as assigned.

Requirements

• B.A. in health care administration, business, or related field. Master’s degree preferred.
• 5-7 years Healthcare Revenue Cycle Management experience overseeing a healthcare revenue cycle and associated staff
• Strong background in financial management and knowledge of federal and state laws and requirements relating to healthcare management.
• Prior experience leading various areas of revenue cycle (billing, collections, denials etc.) with proven success in achieving revenue cycle efficiencies and improving cash flow
• Demonstrated experience in directing and leading others
• Extensive experience billing Medicare, Medicaid, VA/Government plans, and Commercial insurance.
• A strong working knowledge of computer software and hardware, preferably including working with data processing in a medical environment .

Summary

Slocum Orthopedics is recruiting for a Director of Revenue Cycle Management to provide direction for RCM departments and processes, including billing, coding, prior authorization, and associated functions

Slocum is an EEO/AA/M/F/Vet/Disability employer.