Scope: Director of Revenue Cycle Management is an integral member of the leadership team and is responsible for leading and managing front-end and back-end revenue cycle activities of Billing, Coding and Patient Financial Services. Responsible for the overall performance including strategic planning, analysis, and continuous quality and productivity improvements of the team. Accountable for key revenue cycle outcomes and for fostering team atmosphere between internal departments as well as external stakeholders.

Essential Duties and Responsibilities:

• Manage a high performing team that is focused on the front end and back end of the revenue cycle process, including but not limited to; insurance verification, authorizations, upfront collections, financial counseling, coding, billing, and cash posting, AR management etc. in compliance with organizational standards and federal, state, and local laws.

• Leadership oversight of the clinical administrative teams. Drives consistency, production, and efficiencies in the clinical administrative function.

• Build and nurture relationships with external business partners and internal leadership.

• Leads contract management and negotiation including fee schedules. Build relationships within professional networks as well as with payors and other external stakeholders.

• Leverage technology to optimize workflows that drive efficiency, quality, and accuracy.

• Coordinate third-party audits and denial management processes, including tracking trends and responding with potential process improvements to reduce future denials.

• Ensure that business processes are designed to ensure the confidentiality of patient protected health information and meet HIPAA standards.

• Create strategies to identify root cause surrounding billing and coding issues and concerns and works to create processes to address those issues and potential improvements.

• Demonstrates leadership skills in motivation, managing change, delegation, conflict resolution, and written and oral communication.
• Fosters effective working relationships with and among employees, as well as with clients and staff from other departments.
• Lead initiatives to resolve problematic trends and resolve difficult account issues.
• Assist in identifying, recommending, and implementing operational changes that will improve service, productivity, quality, and/or financial performance of the organization.
• Develops a culture that is customer centric and supportive of staff, fostering teamwork and high performance. Oversee training, personal development, retention, and mentoring.
• Develop and maintain written departmental policies.
• Ensures appropriate collection policies and procedures.
• Reports and monitors key metrics and maintains at appropriate level.
• All other duties as assigned.

Additional Skills and Abilities:

• Must possess a comprehensive knowledge of revenue cycle functions and systems, physician practice revenue cycle operations, revenue metrics and analytics.
• Must have strong management and leadership skills that emphasize team building and collaboration. Not afraid to jump in and help with backlogs or projects.
• Excellent communications skills, written and verbal with ability to provide clear direction to staff as well as presentation skills.
• Proficient with computers and their applications including EMR's, Practice Management systems, databases, and Microsoft Office products such as Outlook, Excel, and Word.
• Have a track record of leadership success in healthcare revenue cycle management.
• Demonstrated knowledge of the federal, state, and local regulatory requirements around medical billing and coding as well as CMS and payer regulations.
• Ability to work independently.
• Able to manage multiple projects at once, ability to work efficiently and effectively under tight deadlines.
• Demonstrates advanced analytical, evaluative, problem solving and decision-making, fostering innovative approaches to situations/processes/issues.
• Strong collaborative leadership qualities, willing to work side by side with staff when “hands on' approach is needed.
• Experience in a complex healthcare organization preferred with oncology experience highly desirable.