POSITION SUMMARY

The Director of Revenue Cycle is responsible for the oversight of the daily operation of the billing team through direct management. This position is responsible to ensure the accuracy and timeliness of charges billed and payments received. This includes the successful resolution of outstanding patient and payer payments, claim denials, underpayments, incorrect payer adjudication, payment appeals and grievance, amongst other related activities. This position works closely with VP, Controller Revenue Cycle and the Finance team.

Work is typically performed in an office environment, but this position may have the option to work from home. The specific statements for this job description are not intended to be all inclusive. They represent typical elements considered necessary to successfully perform the job. 

REPORTING RELATIONSHIPS

The position reports to the VP, Controller Revenue Cycle. The following teams will report to this position: Billing, Accounts Receivable, Payment Posting and Collection team(s).

ESSENTIAL JOB DUTIES and FUNCTIONS

While living and demonstrating our Core Values, the Director of Revenue Cycle will:

• Provide continuous monitoring and active management of all revenue cycle processes
• Manage, direct and oversee the daily workload of the Billing/AR/Payment Posting/Collection team(s)
• Ensure compliance with federal/state laws and regulations and billing and collection policies in order to facilitate attainment of accounts receivable targets. 
• Establish and monitor best practice and standards to control the integrity and quality of data throughout the revenue cycle 
• Establish and recommend changes to operating models which affect the revenue cycle 
• Review, design and implement processes surrounding patient and insurance billing
• Develop and maintain an infrastructure for timely and accurate submission of claims and issuance of patient statements
• Develop and maintain collection procedures, minimizing contractual and bad debt write-offs and maximize cash collection
• Monitor collection processes to determine cash flow improvement opportunities
• Perform ongoing trend analysis to ensure compliant contractual third-party payer reimbursement and work with appropriate individuals to resolve discrepancies
• Perform ongoing trend analysis of third-party payer denials. Develop training programs for front desk, billing, and coding staff to reduce/eliminate denials
• Prepare weekly aging report (if necessary) for items that need to be followed up with insurance carriers 
• Develop, recommend and implement policies and procedures for the department
• Monitor adherence to policies and established procedures
• Continuously gather, monitor and analyze departmental productivity
• Supervise, manage and mentor staff to aid in development of management skills
• Actively participate in staff development, training and assessments to support industry best practice
• Lead meetings with staff, leadership and third-party payers 
• Attend meetings such as weekly operations meetings, staff meetings, and others as required
• Provide backup support for the Billing Department at clinical huddles, meetings, and organizational wide departmental meetings, on an as needed basis
• Assist the VP, Controller Revenue Cycle with compliance and site review of Chapter 9 (Sliding Fee Discount Program) and Chapter 16 (Billing and Collections) of the Health Center Program Compliance Manual then in effect issued by HRSA’s Bureau of Primary Health Care to maintain TWCCH’s accreditation as a Look-Alike and promote readiness for a new access point FQHC designation 

QUALIFICATIONS

• Bachelor’s Degree preferable in Accounting, Finance, or Healthcare Administration
• 3-5 Management experience required
• 10 - 15 years’ experience in Accounts Receivable and Collections
• Strong analytical thinking
• Management experience
• Excellent verbal and written communication skills
• Detail oriented and timely delivery of projects 
• Excellent problem solving, time management and organizational skills
• Moderate proficiency in Microsoft Office software
• FQHC multi-specialty Billing and Coding experience preferred
• Understanding of billing systems platforms
• Must be focused, self-directed, organized, and have demonstrated problem-solving abilities
• Accurate and precise attention to detail
• Understands the “big picture” and is able to juggle many priorities