Senior Vice President, Revenue Cycle Management- Remote

Med-Metrix; Parsippany-Troy Hills (NJ); On-site; USD 180,000 - 320,000; Full time

Job summary

Med-Metrix is seeking a Senior Vice President, Revenue Cycle Management to lead and optimize the Revenue Cycle Departments for client accounts in a high-stakes environment. The role emphasizes collection of outstanding insurance balances, appeals of denied claims, and A/R resolution with a strategic, client-centric approach.

The ideal candidate has 10+ years in financial leadership, strong regulatory and HIPAA experience, and proven ability to drive process improvements across multiple campuses

Qualifications

• 10+ years in progressively responsible financial leadership roles, preferably in acute care setting or revenue cycle management
• Analytical and problem solving skills, understand complex reimbursement structures and apply regulations to billing processes
• Knowledge of governmental, legal and regulatory provisions related to collection activity
• Knowledge of insurance company practices regarding reimbursement
• Strong communication and stakeholder management across levels and remote locations

Responsibilities

• Oversee operations of Revenue Cycle Departments in collecting outstanding balances and appealing denied claims
• Analyze and report on payment trends and denials; identify and recommend corrective actions
• Maintain knowledge of healthcare regulations and managed care contracts
• Support Business Development during the sales process
• Ensure HIPAA compliance and protect PHI; report violations
• Collaborate with clients and internal teams to resolve complex billing issues

Skills

Analytical thinking

Regulatory knowledge

Team leadership

Education

BS in Accounting or Finance

MBA/CPA desirable

Tools

Microsoft Office Suite

Job description

Job Purpose

The Senior Vice President, Revenue Cycle Management is responsible for overseeing the Revenue Cycle Departments operations in collecting outstanding insurance balances, appealing denied claims, and resolving A/R for our clients.

Job Purpose

The Senior Vice President, Revenue Cycle Management is responsible for overseeing the Revenue Cycle Departments operations in collecting outstanding insurance balances, appealing denied claims, and resolving A/R for our clients.

Duties And Responsibilities

• Provide assistance/resolution to external and internal client inquiries
• Prepare reports or logs as required
• Act as a technical expert in regards to financial class responsibility, to answer questions raised by clients and team members
• Maintain a current working knowledge of all healthcare related issues and regulations especially Managed Care contracts
• Responsible to report any detected trends in payments or denials, as well as procedural problems, to the client. Recommendations regarding the correction of these trends and/or problems should also be reported.
• Learn and comply with organizational and departmental policies and procedures
• Analyze and solve problems quickly and thoroughly
• Establish realistic goals and priorities concurrent with organizational objectives
• Responsible for ensuring that remote client access to is disabled for terminated or transferred employees when applicable in a timely fashion
• Other duties as assigned
• Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards and enforce such for all direct reports
• Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties for your respective team
• Report any security or HIPAA violations or concerns for your team to the HIPAA Officers in a timely fashion

Qualifications

• BS in Accounting or Finance, MBA and/or CPA highly desirable
• 10+ years in progressively responsible financial leadership roles, preferably in acute care setting or comparable revenue cycle management company
• Analytical and problem solving skills, the ability to understand complex reimbursement structures and the ability to apply contractual and governmental regulations to billing processes
• Knowledge of governmental, legal and regulatory provisions related to collection activity
• Knowledge of insurance company practices regarding reimbursement
• Provide support to the Business Development team during the sales process
• Team building and cooperative work environment preferred
• Proficiency in Microsoft Office Suite
• Strong interpersonal skills, ability to communicate and manage well at all levels of the organization and with staff at remote locations essential
• Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
• High level of integrity and dependability with a strong sense of urgency and results-orientation
• Excellent written and verbal communication skills required
• Gracious and welcoming personality for customer service interaction

Working Conditions

• Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes
• Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
• Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
• Work Environment: The noise level in the work environment is usually minimal.

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.