Position Title: Director, Revenue Cycle Management (RCM)
Position Summary
The Director of Revenue Cycle Management for Regional Business Offices will play a pivotal role in shaping the success of a rapidly growing organization in the Dermatology sector. As new practices are added, this Director will be responsible for overseeing and integrating them into the organization’s revenue cycle standards and performance goals. The ideal candidate will be a proactive, results-oriented billing professional with a strong background in revenue cycle management and a commitment to excellence in a dynamic environment.
Essential Responsibilities
- Develop, implement, and maintain standardized billing policies and procedures in compliance with SOPs, ensuring maximum collections and regulatory compliance.
- Serve as a liaison among accounting, billing, operations, and clinical teams to drive efficiency and streamline processes.
- Perform data quality assurance and analytical reviews to ensure integrity in billing and collections data.
- Collaborate with the Operations team to communicate policies and procedures, including providing Denial Management reports to reduce front-office errors and optimize payment collection.
- Oversee billing and collections operations for commercial and government reimbursement, ensuring accuracy and timeliness in billing, data entry, charge adjustments, and payment processing.
- Partner with the Credentialing Team to ensure a smooth transition for start-up and newly acquired locations, supporting uninterrupted cash flow and efficient billing processes.
- Support and coordinate with the RCM Strategic Projects Director to ensure prompt follow-up on all claims.
- Manage third-party claim resolutions, including denials and appeals, and assess reimbursement management to align with budget goals.
- Evaluate adjustments to receivables and implement action plans to minimize avoidable adjustments.
- Monitor changes in industry reimbursement standards and adjust charging patterns accordingly.
- Adhere to the Red Flag Policy and Procedures.
Qualifications
- Bachelor’s degree in Business Administration, Accounting, Finance, or a related field (Master’s degree preferred), or equivalent healthcare industry experience.
- A minimum of 15 years of progressive experience in revenue cycle management, including patient accounts, accounts receivables, payment posting, claims processing, and denial management.
- +7 years of management experience in revenue cycle operations.
- Proven strategic thinking skills, with the ability to align department goals with organizational growth.
- Proficiency in Microsoft Excel and familiarity with other billing platforms.
- Understanding of medical coding systems, including ICD-10, CPT, HCPCS, APG, APC, and revenue codes, as well as industry reimbursement methodologies.
- Ability to identify root causes and prioritize corrective actions effectively.
Knowledge, Skills, and Abilities
- Strong decision-making skills with the ability to develop and communicate procedural guidelines.
- Analytical abilities to investigate information, draw conclusions, and generate actionable insights.
- Strong communication skills, with the capacity to deliver presentations and foster collaboration across teams.
- Proficiency in supervising and training employees, with a focus on prioritizing, organizing, and scheduling work assignments.
- Advanced knowledge in the development of policy and procedural documentation.
- Employee development and performance management expertise.
- Familiarity with accreditation and certification requirements.
- Knowledge of medical credentialing standards and medical staff policies and regulations.
Due to the high volume of applications, candidates who do not receive feedback within 14 days should consider their application unsuccessful.
