Revenue Cycle Management (RCM) Director

Revenue Cycle Management (RCM) Director - Medical Centers/Managed Care

Orlando, FL

Large and fast-growing multi-specialty medical practice with 18 locations seeking an experienced, operationally minded and hands-on RCM Director to help manage its RCM Department.

RCM Director would be responsible for optimizing and improving current RCM and for preparing and reporting monthly, quarterly, and annual financial results, financial and operating KPIs, monthly dashboards and company forecasts, and assisting with financial audits. 

RCM Director will be significantly involved in finance, working closely with the executive management team.  Ideal candidate will have experience with the Medicare Advantage Program and other managed care programs and will be comfortable working with both physician leadership and business executives.

Primary Responsibilities:

• Experienced within revenue cycle functions of medical billing, coding, cash posting, collection and A/R.
• Maintain Charge Master and payer contractual rates in EMR/PM system
• Maximize workflows of RCM to decrease coding errors, cash posting and achieve 45 DOS or less
• Assess overall performance, processes, KPIs and implement improvements.
• Report trended daily, weekly, monthly and quarterly metrics
• Manage relationship with third-party debt collectors
• Track and monitor the performance of internal and outsourced billing teams and coding procedures.
• Perform internal and external issue resolution and work with a third-party billing group.
• Manage and perform provider billing and coding audits 
• Train, educate and mentor staff
• Strong understanding of payor guidelines and compliance and implement updates to policies when needed.
• Other duties as assigned

Qualifications:

Education:

• Bachelor's Degree with major in Business, Accounting or Finance required
• Master's Degree in Business Administration or Health Care Administration preferred, not required

Experience:

• 8 years of Revenue Cycle Management experience in the healthcare industry
• Experienced with provider billing audits, as well as assessing, improving, tracking billing, coding operations, denial reporting and key metrics
• Experienced supervising RCM department
• Working knowledge of risk adjustment research, submission and tracking with payers is highly desirable

Certification/Licensure:

• Certified coding certification preferred.

Required Skills:

• Good command of Excel, Word, Power Point
• EMR systems preferred eClinicalWorks
• Working knowledge of EDI systems such as TriZetto and Availity
• Ability to communicate clearly in writing and verbally with good interpersonal skills
• Ability to complete assigned tasks with minimal supervision and meet deadlines
• Knowledge of Medicare Advantage, Medicaid and other medical insurance programs (required)

Job Type: Full-time

Reports To: Chief Financial Officer