Director, Revenue Cycle Manager

Description

Looking for the opportunity to build a team? Enjoy the challenge of centralizing a process?

Clear Sight Partners is a building a premier destination for fully integrated ophthalmology, medical optometry and optical retail services designed to provide comprehensive eye care to our patients. We have united 16 locations across the area to serve our market and are currently in a high-growth phase.

We’re looking for a high energy Revenue Cycle Manager to join our team to support the centralization of revenue cycle processes including providing your expertise to support our technology implementation.

Requirements

As a Revenue Cycle manager, you will be responsible for centralizing our pre-authorization, billing and AR processes by defining the appropriate resources, and best practices for revenue cycle management and providing continuous improvements. You’ll work closely with our technology and project management team to ensure our new technology can provide the most efficient and compliant solution for managing the revenue cycle.

Essential Functions and Responsibilities

• Promote revenue cycle improvements throughout the organization including working with appropriate individuals in medical records, billing, denial management to aid in the resolution of identified revenue cycle issues.
• Manage actions relating to delinquent accounts, collection agencies, special adjustments, and/or write-offs.,
• Define problems, collect data, establish facts, and draw valid conclusions.
• Maintains up-to-date expertise and knowledge of healthcare billing laws, rules, regulations, and developments necessary for the organization to make informed business decisions.
• Manage the reimbursement, coding & compliance, information systems, and credentialing.
• Monitor and participate in the review and negotiation of third-party payer contracts.
• Prepare analysis reports pertaining to Accounts Receivable for management
• Implement and monitor collection procedures and policies, minimizing contractual and bad debt write offs, and maximizing cash collections.
• Set goals, communicate expectations to staff, and follow-up as needed.
• Performs billing tasks assigned by management which may include data entry, claim review, charge review, accounts receivable follow-up, or other related responsibilities.

Qualifications

• Bachelor’s degree in a relevant area of expertise such as business or finance
• Medical Billing Coder Certification
• 3+ years in a revenue cycle managerial role within a healthcare organization demonstrating successful team leadership
• Experience leading cross-org discussions and working with a matrixed team of stakeholders to achieve common goal.
• Financial management skills including the ability to financially analyze data for operations, auditing, and forecasting; basic accounting knowledge; A/R and reserve analysis; and staffing and financial reporting skills.
• Extensive knowledge on critical business processes, primarily Billing, Collections, Dispute and Denial Management including working with out of network claims, claim submission requirements, and compliance for all payers.
• Current and in-depth knowledge of all Federal and State regulations related to billing and insurance
• Prior experience with accounting and/or EMR systems implementation

Skills and Abilities

• Ability to work independently within a start-up environment
• Interpersonal skills necessary to communicate vision and leadership to employees and other stakeholders
• Strong negotiation and facilitation skills to effectively influence change
• Analytical skills to interpret financial data and make recommendations to fully capitalize on available opportunities
• Highly organized with developed time management skills
• Excellent verbal and written communication skills
• Ability to develop presentations to effectively communicate current state, future state and other key stakeholder information
• Experience in computer programs such as EMRs, Word, Excel, PowerPoint