Directs operational aspects of accounts receivable outsourcing engagements, manages teams, supports clients, and provides expertise on healthcare reimbursement, financial responsibility, denials, and payment trends. Ensures regulatory, HIPAA, information security, governance, and internal-control compliance while overseeing performance, reporting, issue resolution, and client relationships.
Job Purpose
The Director, Revenue Cycle Management is responsible for managing all operational aspects of our AR outsourcing engagements including overseeing their teams and maintaining a positive relationship with their clients.
Duties and Responsibilities
- Provide assistance/resolution to external and internal client inquiries
- Prepare reports or logs as required
- Act as a technical expert in regards to financial class responsibility, to answer questions raised by clients and team members
- Maintain a current working knowledge of all healthcare related issues and regulations especially Government payors
- Responsible to report any detected trends in payments or denials, as well as procedural problems, to the client. Recommendations regarding the correction of these trends and/or problems should also be reported.
- Maintain a professional attitude snd confidentiality at all times
- Learn and comply with organizational and departmental policies and procedures
- Establish realistic goals and priorities concurrent with organizational objectives
- Adhere to all company policies and procedures including, but not limited to those identified within the Standards of Business Conduct and the Employee Handbook, as may be amended from time to time. Adhere to all applicable laws and regulations and the company's governance/compliance program.
- Responsible for reporting violations of the company's policies and procedures, Standards of Business Conduct, governance program, laws and regulations through the company's Help Line or other mechanism that may be available at the time of the violation. Assist with internal control failure remediation efforts.
- Ensure concerns with internal control design or performance and process changes that impact internal control execution are communicated to management
- Possess a full and complete understanding of the internal control requirements within their area of ownership/responsibility. Responsible and accountable for internal control implementation and performance within their area of ownership/responsibility. Ensures proper internal control change management protocol is followed and communicated.
- Responsible for ensuring that remote client access to is disabled for terminated or transferred employees when applicable in a timely fashion
- Other duties as assigned
- Understand and comply with Information Security and HIPAA policies and procedures at all times and ensure all direct reports are trained and in compliance of said policies and procedures at all times
- Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards and enforce such for all direct reports
- Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties for your respective team
Qualifications
- Bachelor’s Degree required
- 10 years minimum experience in a physician business office setting or similar setting
- 7 years minimum experience managing physician receivables
- Prior Management experience required
- Knowledge of governmental, legal and regulatory provisions related to collection activity
- Knowledge of insurance company practices regarding reimbursement
- Ability to work well individually and in a team environment
- Must be reliable, responsible, goal oriented and flexible
- Proficiency in Microsoft Office Suite
- Strong interpersonal skills, ability to communicate well at all levels of the organization
- Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
- High level of integrity and dependability with a strong sense of urgency and results oriented
- Excellent written and verbal communication skills required
- Gracious and welcoming personality for customer service interaction
Working Conditions
- Occasional travel to client locations
- Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.
- Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
- Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
- Work Environment: The noise level in the work environment is usually minimal.
Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.
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