Sr Director of Revenue Cycle Management

Sr. Director of Revenue Cycle Management

Avamere Living

25117 SW Parkway, Wilsonville, Oregon 97070

 

Job Summary

A Sr. Director of Revenue Cycle Management (RCM) for Skilled Nursing Facilities and Retirement Campuses (SNF) manages the financial aspects of healthcare services for patients, from registration to final payment. The Director of Revenue Cycle is responsible for the direction and leadership of operational, financial, programmatic and personnel activities for Revenue Cycle, including provider enrollment, claims, payments, credit balance, insurance reimbursement, and self-pay management. The Sr. Director of Revenue Cycle Management works closely with all Avamere employees and supports enterprise-wide projects and initiatives that relate to Avamere priorities, health care legislation, compliance, system redesign, improved revenue goals and/or reduced costs. This position will also assess personnel and fiscal implications of organization changes; assist staff in implementation changes; monitors and analyze the impact of changes. 

Essential Duties and Job Responsibilities

• Prepare and interpret AR productivity data, claims data, reimbursement analyses, and other data analytics for reporting trends, root cause analyses, and audit findings.
• Provide financial analysis and reporting for Senior Management as required.
• Maintains functional accountability for the insurance claim function which includes: monitoring the status of claims, denials management and tracking ADR requests in partnership with Health Services Division
• Develop and implement operational policies and procedures governing revenue cycle management and billing compliance for the organization.
• Investigate and analyze issues, root causes, patterns, or trends and identify and implement process improvement actions in support of revenue cycle objectives.
• Optimize revenue cycle management systems to improve efficiency and accuracy of both billing and collections efforts
• Responsible for the effective management and leadership of a team. This includes, but is not limited to: hiring, training, coaching, evaluating and managing performance, allocating compensation, effectively handling employee relations issues, managing terminations.
• Oversee Contracting and Credentialing Department and department function.
• Reviews and supervises all provider/payor contracts before agreements are signed and implemented. 

This includes:

- Billing: Ensuring accurate pre-authorizations and eligibility verification for residents

- Claims: Submitting claims and processing remittances

- Collections: Managing and collecting resident payments

- Overseeing the business office at facilities and campuses

- Supervising Regional Revenue Cycle Managers, Senior RCM, billing and collections staff

- Maintaining patient billing and reimbursement systems

- Planning and implementing business office strategies

- Optimizing insurance data management and cash application

- Supporting enterprise-wide projects and initiatives

- Assessing the impact of organizational changes

- Analyzing and addressing rejections and denials as soon as possible

- Monitoring performance, especially during staffing changes

- Establishing benchmarks for organizational needs

- Identifying process gaps and opportunities for improvement

- Adjusting internal resources or outsourcing to meet expectations

Minimum Qualifications

• Minimum of 10 years direct experience required
• A minimum of five years of progressive leadership and managerial experience at a large or multi-facility organization (preferably in skilled nursing) required

Preferred Qualifications

• Extensive knowledge of operational revenue cycle management with PointClickCare experience preferred.
• Ability to demonstrate strong strategic thinking, collaboration, leadership, problem solving and communication skills with all levels of the organization required
• Strong reimbursement knowledge and understanding of SNF regulations, best practices, and quality improvement processes required
• Knowledge of state and federal regulations required
• Strong organizational and communication skills required
• Excellent attention to detail required
• Ability to multi-task and remain calm under pressure with excellent customer service skills required
• Excellent organizational and project management skills required

Avamere Living is an Equal Opportunity Employer and participates in E-Verify.