Director of Revenue Cycle Management

The Director of Revenue Cycle Management directs and manages all policies, functions and staff of the EVMS Medical Group (EVMSMG) revenue cycle team. This includes, but is not limited to, providing revenue projections and communicating this information regularly with the EVMSMG leadership, billing, collections of patient accounts, compliance with third-party payer regulations, cash posting, employee productivity and ongoing improvement to key revenue cycle indicators. These key indicators include, but are not limited to, accounts receivable days, cash collections goals and posting, bad debt, denials, and contract management activities related to patient account management.

Designs and executes key strategies to drive collection of appropriate reimbursement

Leads and provides operational directives for all activities related to claims management and collections of accounts receivables and ensures timely, efficient cash collections to support overall financial goals of EVMSMG.

Ensures that all payment posting is done in accordance with established contracts and EVMSMG standards.

Develops processes and policies for exception handling, appeals and denials and balance billing

Monitors billing compliance with all third party payer regulations

Ensures that customer satisfaction is achieved through courteous and effective communication, problem solving and efficient processes

Identifies, develops and implements objective and meaningful performance metrics associated with the Revenue Cycle Management function

Prepares and analyzes reports to monitor trends and determine operational deficiencies and in collaboration with the rest of the EVMSMG leadership team, implements corrective-action plans as necessary.

Forecasts revenue projections based on staffing, department operation models, billable services, and payer reimbursements.

Consistently drives best practices in Revenue Cycle Management operations in order to achieve:

Improved administrative processes in order to increase cash flow, reduced accounts receivable days outstanding, and enhanced billing accuracy to minimize payer rejections or denials

Drive technology and operational improvements that will reduce administrative costs in the Revenue Cycle operations

Communicates and collaborates with each departments leadership in an effort to improve efficiencies and streamline processes for EVMSMGs billing-revenue cycle.

Responsible for performance management of EVMSMG personnel who provide billing services.

Completes all employee performance evaluations of direct reports and provides feedback to managing staff to ensure consistency in application of performance-review process.

Works with department front desk and billing teams to conduct training around proper entry for patient registration/check-out and other data to assure all information is collected that is needed for billing.

Coordinates training with the IT team regarding the functionality and Patient Account Services team to provide content regarding insurance carrier billing guidelines.

Maintain effective working relationships with clinic operations, employees, insurance carriers, corporate, regional and Revenue Cycle Management staff.

Exercises initiative, judgment, discretion and decision-making to achieve organizational objectives.

Serves as a resource along with the Internal Audit and Compliance team for department billing staff regarding CPT/ICD10 coding.

Assists in preparation of annual departmental budgets, as needed.

Maintains knowledge of current regulations and policies of Federal, State and private payers; keeps impacted departments informed of changes, revisions, and updates.

Stays abreast of latest developments and trends in field of Patient Accounts.

Maintains confidentiality in all matters that include Patient Health Information and Employee Data.

Other duties as assigned by EVMSMG, CEO or his/her designee.

MANAGEMENT AND SUPERVISORY RESPOSIBILITIES:

Direct supervisor of EVMSMG billing staff to include but not necessarily be limited to, Patient Accounts, Credentialing, and Coding/Charge Capture.

Bachelors degree. Minimum of seven (7) years of progressively more responsible positions in revenue cycle management operations.