Sr. Director, Revenue Cycle
Company: The Staff Pad
Location: Portland
Posted on: April 28, 2024
Job Description:
Job Description
The Staff Pad has partnered with the largest community-based
behavioral health and substance use treatment services organization
in the state of Oregon. Our client is a Certified Community
Behavioral Health Center seeking a Sr. Director of Revenue Cycle to
join their organization.
The Sr. Director, Revenue Cycle's responsibilities are managing the
operations of the billing department. Key focus areas are planning
and directing patient insurance documentation, coding, billing, and
data processing to ensure accurate billing and efficient account
collection. Additional areas of responsibility include
credentialing and payer contract management. Duties also include
leadership and oversight of the revenue cycle workforce.
Ultimately, a top-performing Sr. Director, Revenue Cycle should
seek ways to improve the functioning of the Revenue Cycle
Department.
Essential Duties
- Lead the Revenue Cycle Department
- Optimize the structure of department's workflow and
staffing.
- Responsible for account management, communications with
insurance providers, collections, cash posting, contract analysis,
and billing.
- Efficiently manage patient complaints in respect of billing and
collections.
- Review and approve financial or medical hardship discounts /
write-offs.
- Develop policies and procedures across the department
- Ensure Effective Accounts Receivables (A/R) Performance
- Ensure claims are submitted quickly, accurately and in a timely
manner.
- Ensure patients understand statements and pay outstanding
balances.
- Monitor A/R performance and monitor aging or uncollected
balances.
- Audit current procedures to monitor and improve efficiency of
billing operations.
- Oversee the coding and denial management processes
- Contract Management
-
-
- Oversee the negotiation, creation, and management of contracts
within the healthcare industry.
- Ensure compliance with laws and regulations governing
healthcare contracts.
- Review and analyze contract terms and conditions.
- Collaborate with internal departments to ensure contract terms
meet organizational needs.
- Monitor contract performance and compliance.
- Keep abreast of changes in the healthcare industry that may
impact on contracts.
- Credentialing Oversight
- Ensure compliance with regulatory and accreditation standards
related to provider credentialing.
- Collaborate with internal departments, such as People and
Culture, to ensure provider credentialing requirements are
met.
- Manage staff performance
- Provide regular feedback, performance reviews, and one-on-one
meetings.
- Oversee the hiring and training of staff.
- Ensure Compliance to Applicable Rules and Regulations
- Routinely monitor billing compliance by reviewing
documentation, coding, and billing. This includes working with
Information Technology (IT) and the providers to improve accurate
charge capture when CID-10-CM and CPT/HCPCS codes are updated.
- Work with the organization's HIPAA Privacy/Security Officer to
ensure new hire and annual training is conducted with your entire
department workforce.
- Perform other job-related duties as assigned Qualifications
Education:
Bachelor's degree in finance, Business Administration, Healthcare
Administration, or related field and certification in revenue cycle
management specifically.
Experience:
Ten (10) years healthcare revenue cycle experience.
Proven leadership and customer service skills are also required for
this position.
Experience with EPIC Electronic Health Record (EHR) system
preferred.
Specialized Knowledge, Skills, and Abilities:
- Sound knowledge of health insurance programs and contracts
- Possess in-depth knowledge and understanding of Medicare,
Medicaid, and Managed Care regulations.
- Proficiency in Excel including but not limited to Pivot Tables
and Lookup functions
- Ability to adapt to changing technology
- Ability to read, interpret, research, explain and apply laws,
rules, regulations, policies, and procedures related to program
business
- Ability to prepare complex reports
Keywords: The Staff Pad, Tigard , Sr. Director, Revenue Cycle, Executive , Portland, Oregon
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