Revenue Cycle Director: Optimize Revenue & Cash Flow

Spring Branch Community Health Center; Katy (TX); Hybrid; USD 120,000 - 180,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Life insurance

Short-term disability insurance

Long-term disability insurance

Critical Illness

Hospital Indemnity

PTO and paid holidays

EAP

Job summary

Spring Branch Community Health Center is seeking a Revenue Cycle Director to lead the organization’s reimbursement strategy and oversee all related operations, including call center, scheduling, eligibility verification, billing and collections. Collaboration with clinical, operational, finance, HR and credentialing will foster a positive environment and align activities with CFO-driven metrics.

The ideal candidate will have a bachelor’s degree in health care administration, at least four years

Qualifications

• Bachelor’s degree in health care administration or related field.
• Four years of health care revenue cycle experience, preferably in a federally qualified health center (FQHC).
• Current knowledge of FQHC/medical office practices, procedures and billing program, Compliance, Fraud and Abuse rules as related to billing and collecting with Federal, State and third-party payers.
• Minimum of three years supervisory experience.
• Ability to analyze complex data, including fiscal and performance data, and communicate the results.
• Must be proficient in Microsoft Office Suite and practice management/electronic health records systems, preferably eClinical Works.
• Ability to communicate effectively orally and in writing and work well with all levels of staff.

Responsibilities

• Providers oversight and supervision to all revenue cycle managers including, but not limited to, call center, eligibility, front desk, insurance verification and billing.
• Supports the full revenue cycle through data collection, reporting, analytics and KPI monitoring.
• Manages department budgets and regular reporting requirements.
• Coordinates with clinical operations to reduce preventable operational errors, minimize payment denial, and improve patient care and experience.
• Safeguards the security of cash payments and collection of patient accounts; monitors the accounts sent for collection and reimbursement from Federal, State, insurance company, or other third-party payers; reviews, evaluates and verifies the accuracy of payments and enrollment in programs for compliance; investigates and resolves discrepancies.
• Approves and signs off on all department related expenses, refunds to patients and reimbursement of overpaid fees to insurance carriers.
• Maintains compliance and prevents Fraud & Abuse issues related to billing and collecting patient revenues. Keeps staff current on compliance and Fraud & Abuse issues.
• Manages merchant services vendor contracts for patient payment and collection activities.
• Manages clearinghouse vendor relationship and maximizes services available through that vendor.
• Works with the Accounting Department to maximize utilization of Texas Health and Human Services contract funding.
• Conduct annual review and update of fee schedule (charge master) and sliding fee discount schedules.
• Conduct semi-annual review of all insurance contracts and evaluate opportunities for new contracts.
• Coordinate ongoing provider documentation and coding training.
• Promote SBCHC pharmacy services to all patients.
• Identify opportunities to increase revenue from current services.
• Research and identify new revenue sources, such as billing fee-for-service outside of FQHC reimbursement.
• Develop and implement procedures for billing and collection from new service lines, such as optometry, case management and nutrition services.
• Develop and monitor revenue cycle KPIs.
• Participates in organizational strategic planning activities to ensure the delivery of comprehensive and coordinated health services; serves on committees and task forces to address specific issues and represent the department as assigned; attends meetings and conferences as assigned.
• Develops, maintains and enforces departmental policies, procedures, and work practices to ensure maximum accuracy of patient demographic, financial and insurance data.
• Assures maximization of collections, accuracy of account numbers, billing system integrity, signature authority, codes and insurance status within the framework of what is legal and in compliance with rules, regulations and laws.
• Works with Accounting Department to ensure accurate and timely recording of patient revenue and collections.
• Formulates systematic retention, protection, transfer, and disposal of billing records.
• Coordinates with the IT department and software vendors to monitor and ensure the integrity of the data within the practice management system. Manages the Practice Management side of the Billing system.
• Works on process improvement of Billing functions-using resource sharing and input from sister network FQHCs.
• Leads the implementation of automation and use of artificial intelligence (AI) to facility maximum reimbursements and collections.
• Leads special projects, as assigned.
• Conducts performance reviews as required for assigned staff.
• Performs other duties as assigned by the CFO and/or CEO.
• All Health Center staff members have emergency and disaster response responsibilities. Participates in all safety programs, which may include assignment to an emergency response team.

Skills

Revenue cycle knowledge

Data analysis

Leadership

Communication

Education

Bachelor’s degree in health care administration

Tools

eClinical Works

Microsoft Office Suite

Job description

Spring Branch Community Health Center is seeking a Revenue Cycle Director to lead the organization’s reimbursement strategy and oversee all related operations, including call center, scheduling, eligibility verification, billing and collections. Collaboration with clinical, operational, finance, HR and credentialing will foster a positive environment and align activities with CFO-driven metrics.

The ideal candidate will have a bachelor’s degree in health care administration, at least four years