Director, Revenue Cycle
The Director of Revenue Cycle will be responsible for the governance, oversight and leadership of denial recovery and prevention operations, denial analytics, and the automation of denial prevention solutions. The Director is will provide denial resolution and prevention services across the enterprise, supporting hospitals, clinics, EMS, and other provider groups as necessary. The Director is responsible for the oversight of claim data analyses, elevating meaningful insights, and offering recommendations to senior leadership teams to make decisions that manage and prevent denials. The Director is responsible for the oversight of predictive and automated solutions that proactively monitor for potential denials and initiate value-added actions that revenue cycle, operations, and clinical teams can take to prevent denials.
- Oversees the day-to-day operations of professional billing, denials, appeals/follow-up;
- Works collaboratively with other departments/senior leadership to identify, install, and manage revenue performance improvement initiatives;
- Measures and manages staff performance/productivity and employment standards;
- Promotes continuous process improvements and participates in shared services initiatives;
- Understands and educates on payer rules, regulations, and guidelines to ensure ethical and compliant standards;
- Provides analysis and data-driven recommendations to senior management;
- Demonstrates excellent communication skills, both written and verbal;
- Demonstrates ability to set priorities and manage multiple projects simultaneously;
- Demonstrates respect and regard for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment; and
- Performs other duties as assigned
- Proven knowledge of professional operations including best practices regarding workflow, quality monitoring, coaching, and training to lead a team to maximize cash performance & DSO management;
- Strong reconciliation skills;
- Process expertise in a multi-hospital/physician system and central business office
- Education: Bachelor's Degree Preferred or equivalent experience; MBA a plus.
- Experience: 5+ years’ management experience in revenue operations
- Software/Hardware: Applicable billing and claims software.