Revenue Cycle Director

Little River Medical Center, Inc.; Little River (SC); On-site; USD 110,000 - 170,000; Full time

Benefits offered by this job

Employer matched 403B Retirement Plan

Paid Vacation, Sick, and Holidays

Job summary

Little River Medical Center, Inc. seeks a Revenue Cycle Director to lead and optimize the billing and collections team, improving cash flow and payer relations. You will implement cross-functional processes, monitor regulatory compliance, and drive performance across the department.

Strong leadership and extensive healthcare billing experience are essential. Ideal candidates will guide strategic initiatives, coach staff, and coordinate with finance and network providers to ensure accurate

Qualifications

• Bachelor's degree in accounting, Finance, Business Administration, or Healthcare Administration preferred.
• At least 10 years of healthcare billing experience required.
• Medical billing supervisory experience of 5 years required.
• Experience with remote supervision required.
• Advanced knowledge of ICD-10, CPT, HCPCS codes.
• HIPAA, Medicare/Medicaid regulatory compliance knowledge.
• FQHC experience preferred.
• Proficient with Excel, Word, PowerPoint.

Responsibilities

• Provide innovative workflow solutions to improve revenue cycle efficiency.
• Monitor insurance payer contracts and compliance with regulations.
• Lead revenue cycle operations under CFO supervision.
• Oversee coding audit functions and data interpretation.
• Develop goals aligned with strategic plan and monitor budget and performance.
• Coordinate with providers and other departments to optimize collections.
• Mentor staff and conduct performance reviews.
• Oversee EDI workflows related to revenue cycle processes.
• Assist with related accounting tasks as needed.

Skills

Leadership

Healthcare billing

Remote supervision

Excel

CPT/ICD coding

PowerPoint

Education

Bachelor's degree in accounting, finance, business administration, or healthcare administration

AAPC or AHIMA certification

10 years healthcare billing experience

Tools

Microsoft Office

Job description

The Revenue Cycle Director will provide strong leadership and directly manage all functions of the billing and collections staff 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 daily 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.

ESSENTIAL DUTIES AND RESPONSIBILITIES

include the following but not limited to.

• Provide innovative workflow solutions to improve efficiency within the entire revenue cycle.
• Assures that Medicare credit report information is gathered timely for quarterly reporting.
• Monitor front office errors pertaining to billing procedures and provide timely feedback to CFO and Front Office Manager.
• Updates insurance manuals and provides appropriate guidance to billing staff.
• Provide leadership and direction of revenue cycle operations under the supervision of the CFO.
• Direct and oversee the strategic function and processes for the revenue cycle.
• Provide leadership in the planning, development, and implementation of departmental objectives; develop specific goals and standards that directly support the company’s strategic plan.
• 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.
• Ensure all department 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 Providers and other departments.
• Recommends new approaches, policies, and procedures to influence continuous improvements in the department’s efficiency and services performed.
• Maintains oversight of all credentialing processes to ensure ability to bill for services rendered by newly hired providers as quickly as possible.
• Monitors changes in the medical insurance industry and adjusts procedures accordingly.
• Supervises, trains, and mentors assigned personnel. Evaluates performance and recommends merit increases, promotions and disciplinary actions.
• Maintains knowledge of and comply with established policies and procedures.
• Attend required meetings and participate in committees as requested.
• Participate in professional development activities and maintain professional affiliations.
• Develop and implement solutions to optimize revenue collections.
• Evaluate and develop data driven action plans for efficient, ethical, and productive business practices that lead to patient, employee and physician satisfaction.
• Oversee the daily operations of EDI workflows related to revenue cycle processes.
• Oversee and collaborate on all coding audit functions both internally and externally.
• Conduct meaningful performance appraisals and implement development plans for staff.
• Assist with Accounting tasks as assigned as it relates to the revenue cycle.
• Effectively analyze meaningful financial data as needed and as assigned in order to improve and maintain productivity, performance, and financial outcomes for the company.
• Maintain database of fee schedules and reimbursement.
• Serves as lead coordinator for the Contracting Committee.
• Obtain, review, and interpret all new payer contracts to identify all negotiation points and present them to the Contracting Committee.
• Serves as a point of contact for the center with payer contracts and negotiation.
• Monitor and interpret reporting data to ensure correct reimbursement from payers.
• Other duties as assigned.

SUPERVISORY RESPONSIBILITIES

Direct supervision for Revenue Cycle Manager, Provider Enrollment Coordinator, and Coding Coordinator. Indirect supervision for Revenue Support Supervisor, Patient Services Specialist, Billing Administration Support, Patient Financial Specialist, Billing Specialist, Payments Specialist, and Certified Coding Specialist.

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION and/or EXPERIENCE:

• Bachelor’s degree in accounting, Finance, Business Administration, or Healthcare Administration preferred, but equivalent work experience or secondary education credit hours will be considered.
• At least 10 years of healthcare billing experience required.
• Medical billing supervisory experience of 5 years required.
• Experience with remote supervision required.
• Extensive knowledge of medical terminology and CPT coding required.
• Professional billing certification from AAPC or AHIMA required.
• Advance and current working knowledge of ICD-10, CPT, and HCPCS codes.
• Current knowledge of insurance payer coding and reimbursement guidelines.
• Previous experience with a Federally Qualified Health Center (FQHC) is strongly preferred.
• Proficient with Microsoft Office Suite specifically Excel, Word, and PowerPoint.

LRMC offers benefits such as:

• Employer matched 403B Retirement Plan.
• Paid Vacation time, Sick time, & Holiday's. As well as paid qualifying Administrative Leave.
• Employer Paid Health Benefits: Life / AD&D Policies, Short/Long Term Disability, and a Employee Assistant Plan.