Director, Revenue Cycle Management

Company: AllerVie Health
Location: Plano
Posted on: May 24, 2023

Job Description:

The Senior Director of Revenue Cycle Management will work under the general supervision of the Chief Financial Officer. This position is responsible for ensuring that patient billing and processing of payment receipts are consistently completed timely and in accordance with policy. The Senior Director of Revenue Cycle will minimize bad debt, improve cash flow and effectively manage accounts receivables by managing both 3rd party billing resources and internal billing management practices. This position will coordinate effective management of revenue cycle activities across the organization to include, but not limited to front desk, billing, collections, financial counseling for patients and staff training.


Essential Duties:


Supervise and evaluate assigned support staff in a timely manner to ensure needed support for RCM processing and growth

Ensure accuracy of deposits, demographic and other information entered into the patient billing system

Participate in program/service evaluation activities; facilitate changes in provision of service based on Continuous Quality Improvement results.

Compile and prepare various status reports for management in order to analyze trends and make recommendations

Participate in preparation of annual UDS report

Monitor data integrity for the practice management system. Report problems to the CFO or other appropriate personnel in a timely manner.

Provide a monthly summary on the status of outstanding charges in the oldest column of the Accounts Receivable Aging report for all balances over designated amounts.

Provide monthly report on the status of credit balances. (Unapplied Credit Analysis Report)

Coordinate with the Practice Managers to stay current on credentialing issues, especially in the case of new providers, with an emphasis on scheduling mainly self-pay patients for the new providers until they are credentialed with third party organizations.

Monitor volume of charge and collection posting on a monthly basis to confirm that Billing Specialists are keeping up with patient encounter volume. Recommend and/or implement changes to work schedule or billing resources, as needed

Responsible for ensuring the timeliness of processing and correction of rejected claims

Maintain regular schedule for sending out billing statements in accordance with the Financial Policies and Procedures.

Maintain a regular schedule for writing off bad debts, including a process which requires, and documents attempts to collect or resubmit prior to removing the charge from outstanding receivables. Submit Bad Debt Write Off Report to CFO.

Monitor coding practices among providers to determine potential patterns of under coding or other irregularities

Keep Billing Specialists up to date on third party coverage contracts, assuring that current contractual terms are understood and applied correctly

Work with Practice Managers to assure that patients are informed of requirements such as income and/or insurance verification at the time that the appointment is scheduled. Confirm that patients who have coverage that is not accepted at our organization are made aware of this fact before appointment is scheduled.

Monitor and identify any patterns in remittance advices which would indicate the PSRs are not properly collecting insurance information. In coordination with Practice Manager, initiate retraining and/or other corrective action indicated.

Coordinate the Revenue Cycle Management team to address any deficiencies in staff performance uncovered by internal audits.

Actively participates in and complies with all aspects Corporate Compliance Programs, follow the Program Code of Conduct and obey all relevant laws, statutes, regulations and requirements applicable to Medicaid, Medicare and other State and Federal health care programs.

Participate in CQI, other internal committees, special projects/observances or activities that promote improvements in organizational performance and/or advance the mission, goals and objectives of AllerVie Health.


Qualifications


Minimum Bachelor Degree in Business Administration, Health Care Administration or related field is preferred, and at least seven years experience management in a healthcare revenue management role, or Master's Degree in Health Administration, Public Health, Business or related field and five years experience.

ICD-10 medical coding certification is preferred.

Has knowledge of quality management process.

Must have strong financial management knowledge and experience.

Must be an effective communicator with strong oral, written and presentation skills.

Keywords: AllerVie Health, Plano , Director, Revenue Cycle Management, Executive , Plano, Texas