Job Summary: 

• Provide leadership, operational oversight, and strategic direction to the system-wide revenue cycle process.
• Set and manage key performance indicators for Pre/Post Billing, Follow-Up, Denial and Payment Variances, Customer Service, Payment Operations, Eligibility Assistance and Financial Support programs.
• Analyze AR, Billing, Collections, and other key areas that impact the collection of revenue.
• Develop reporting tools to track key performance indicators and monitor and manage overall collections performance. 
• Present KPI’s to Executive Team and Board of Trustees regularly.
• Work effectively with all levels of management and staff, consultants, and vendors, communicate clearly, concisely, and accurately, verbally and in writing, and achieve results.
• Develops and leads ongoing compliance work plan reviews identifying, assessing, and documenting potential compliance violations.
• Ensure consistent application of A/R adjustment and standard accrual tools to figure appropriate discounts and allowances by payer class and insurance plan.
• Continually assess processes to ensure quality and efficiency and maximized cashflow.
• Understand and enforce Medicare and Medicaid billing compliance and stay abreast of industry requirements.
• Collaborate with Finance on budgets, revenue projections, rate competitiveness, and receivables. 
• Provide monthly closing reports and A/R analysis.
• Manage all billing departmental activities and personnel
• Coaching, training, planning, assigning, and directing work, appraising performance, addressing complaints, and resolving problems. 
• Hiring, promotion, and termination of team members
• Set department goals, measuring performance at regular intervals, and track, monitor, and coach to ensure standards are met and maintained.
• Establish department training and education programs, and compliance initiatives. 
• Ensure department managers and leads are trained in all aspects of position protocols to include succession planning

Skills on Resume: 

• Presentation Skills (Soft Skills)  
• Communication Skills (Soft Skills)  
• Compliance Management (Hard Skills)  
• Financial Analysis (Hard Skills)  
• Process Optimization (Hard Skills)  
• Regulatory Knowledge (Hard Skills)  
• Leadership (Soft Skills)  
• Team Development (Soft Skills)  

Job Summary: 

• Responsible for oversight and management of billing, collections, insurance verifications, and AR management.
• Supports strategic payer contracting initiatives.
• Recommends modifications proactively as it pertains to payment trends, denial management, rejections, etc.
• Review carrier and patient obligations, adhere to state and federal guidelines.
• Coordinates all appeals and assists in payer audits.
• Maintains compliance with the most recent Healthcare and National Uniform Billing.
• Supervises collection function. Tracks analyzes insurance payment denials. Identifies root cause and works with supervisors, peers, and staff to remediate.
• Monitors and evaluates employee performance, provides timely, consistent and appropriate performance feedback.
• Develops employees through coaching, mentoring, and formal/on the job training and development opportunities.
• Responsible for billing system month end close procedures. 
• Responsible for production and/or review of monthly operating reports with explanations of changes in key performance metrics.
• Reviews and manages department P&L consistent with management objectives and budget directives.

Skills on Resume: 

• Billing Management (Hard Skills)  
• Strategic Contracting (Hard Skills)  
• Trend Analysis (Hard Skills)  
• Regulatory Compliance (Hard Skills)  
• Audit Coordination (Hard Skills)  
• Performance Monitoring (Soft Skills)  
• Staff Development (Soft Skills)  
• Financial Reporting (Hard Skills)  

Job Summary: 

• Serves as a point of contact for all new market development as it relates to revenue cycle management. 
• Supporting the evaluation of anchor practices and billing, coding and collecting practices, participation in business development meetings, due diligence investigation, staffing/efficiency analysis and product demos.
• Responsible for assisting with the management of post-live issue resolution following launch of a new market.
• Serves as one of the subject matter experts on all issues related to billing, collections and revenue cycle management that are provided to all markets through national resource team.
• Responsible for managing the revenue integrity work including over/under payments, appeals, payer issue resolution, system management and reporting.
• Operates in a liaison capacity within the Company and with external inquiries such as audits, consulting engagements and surveys
• Manages the national training team and is responsible for ensuring that all training documentation is accurate, complete and of the highest quality to provide value to care centers and staff
• Responsible for departmental policies and procedures, providing recommendations when appropriate and ensuring compliance
• Responsible for staffing to include hiring, termination, coaching and training. 
• Assigns employee workload and reviews productivity compared to company/department standards.

Skills on Resume: 

• Revenue Management (Hard Skills)  
• Coding Expertise (Hard Skills)  
• Problem Solving (Hard Skills)  
• Expert Knowledge (Hard Skills)  
• Liaison (Soft Skills)  
• Training (Hard Skills)  
• Policy Oversight (Hard Skills)  
• Leadership (Soft Skills)  

Job Summary: 

• Ensure that departments, functions, and teams are operating in compliance with payer requirements, patient expectations, as well as the company’s policies and procedures.
• Participate in cross-functional and interdepartmental teams involving process improvement initiatives and projects for the organization.
• Respond effectively to management’s request for specific and/or special revenue cycle projects.
• Coordinate timely month end close process and financial reporting related to revenue cycle process and information technology.
• Report and assist the CFO to implement strategic growth plans.
• Understand the organization’s goals and be able to identify and engage relevant stakeholders to remove barriers.
• Oversee the operations of the billing team, encompassing charge entry, claims submissions, accounts receivable follow-up, and reimbursement management.
• Develop an in-depth working knowledge of practice management systems.
• Design reporting to assure accurate and complete data analysis.

Skills on Resume: 

• Compliance Management (Hard Skills)  
• Team Collaboration (Soft Skills)  
• Project Management (Hard Skills)  
• Financial Reporting (Hard Skills)  
• Strategic Planning (Soft Skills)  
• Stakeholder Engagement (Soft Skills)  
• Revenue Cycle Operations (Hard Skills)  
• Data Analysis and Reporting (Hard Skills)  

Job Summary: 

• Lead the sourcing of acquisitions through existing clinician relationships, proactive outreach, and brokers
• Overseeing the Revenue Cycle Manager, which manages the billing and collections team, developing key metrics, establishing goals, launching new incentive programs, and reporting on overall performance
• Opportunity to develop a strong understanding of technology and software capabilities to maximize systems and reduce claim touch points
• Streamlining billing and collections policies and procedures across the organization, both within the billing and collections department, as well as at the clinic level
• Communicating and quantifying payor issues, as well as developing a strategic plan to approach issues
• Creating strong relationships with payors to improve the credentialing process and confirm that claims are properly adjudicated
• Managing payor contracts to ensure contracts are loaded correctly into payors systems and that providers and the clinics are properly credentialed
• Compiling weekly and monthly financial metrics to share with management team
• Developing policies and procedures for collecting on patient balances
• Working with clinical staff and Revenue Cycle Manager to ensure appropriate coding, billing and support documentation for claims
• Developing protocols and policies to integrate the practices EMR system with the billing and collection mechanisms
• Responsible for complying with all federal, state, and local regulatory agency requirements
• Responsible for complying with all accrediting agencies

Skills on Resume: 

• Relationship Management (Soft Skills)  
• Financial Analysis (Hard Skills)  
• Strategic Planning (Soft Skills)  
• Policy Development (Hard Skills)  
• Claims Management (Hard Skills)  
• Communication Skills (Soft Skills)  
• Technological Proficiency (Hard Skills)  
• Project Management (Soft Skills)  

Job Summary: 

• Directly accountable for the management of the Revenue Cycle management team and financial performance to ensure maximizing the cash collection for the company. 
• Direct oversight to include credentialing, precertification process, charge entry, payment posting, accounts receivable and financial assistance.
• Oversees revenue cycle benchmarking by comparing business processes and performance metrics to best practices in the market, and implements improvements to gain efficiency, lower cost, and higher quality.
• Leads the development of a comprehensive reporting and analytics infrastructure to produce timely management level dashboards to monitor business performance.
• Responsible for establishing key financial and operational measures and reporting on them in a timely manner
• Monthly, quarterly and annual physician revenue cycle reports
• Contractual and bad debt reserve analysis, AR management
• Monthly reporting on entity, departmental and provider and clinic KPIs
• Participates in the development of revenue cycle projections for new physician recruits by estimating future outcomes using historical data, market and economic indicators.
• Planning, assigning and directing work, interviewing and hiring employees, training employees, addressing complaints and resolving problems.
• Leads the implementation of best practice revenue cycle standards to be followed company wide.
• Ensures the management of patient accounts are accurate and timely resulting in the optimization of the entire revenue cycle.
• Assist in the preparation of ad hoc revenue cycle reporting for the executive team to analyze current strategic direction and evaluate new business opportunities.
• Assists with development and communication of annual cycle revenue personnel plan and budgets.
• Seamlessly onboard and transition new physicians and acquired physician practices into the company.
• Responsible for working with practice leadership to identify opportunities for improving cash flow.
• Educates practice management on best practices by reviewing/understanding practice KPI’s and various operational revenue cycle activities

Skills on Resume: 

• Revenue Cycle Management (Hard Skills)  
• Financial Analysis (Hard Skills)  
• Benchmarking (Hard Skills)  
• Data Analytics and Reporting (Hard Skills)  
• Strategic Planning (Soft Skills)  
• Leadership and Team Management (Soft Skills)  
• Problem Solving (Soft Skills)  
• Communication Skills (Soft Skills)  

Job Summary: 

• Leads the identification of opportunities to optimize revenue collection through proper coding, encounter/claims submission, and payment reconciliation across the enterprise
• Manages existing contracts and provides assistance in negotiations to maintain and secure financial agreements with payor sources.
• Leads business process improvement efforts in collaboration with clinical, operational, growth and IT counterparts to develop automated, repeatable processes and systems to optimize revenue collection.
• Independently identifies and pursues revenue improvement opportunities through process improvement and data management.
• Develops and presents ROI-based recommendations to executive leadership, regarding process changes, revenue capture opportunities, staffing changes, or training opportunities that accelerate or maximize revenue collection.
• Performs claims analysis, generates, and presents reporting around KPIs and collaborates with operations and revenue cycle team members to evaluate and resubmit claims submissions 
• Tracks numerous metrics related to the patient engagement cycle including record coding error rates and billing turnaround times to develop sound revenue cycle analysis and reporting.
• Participates in the development of coding and billing strategies, evaluating process relative to Revenue Cycle and making recommendations while ensuring compliance with any relevant rules or regulations (including HIPAA, Medicaid, Medicare, and specific 3rd Party Payors).
• Collaborate with IT and other teams relative to contracting and clinical considerations that impact claims submissions and other reimbursement models and implementing changes and upgrades.
• Manages relations with payers and providers to generate high reimbursement rates and a low level of denials. 
• Partners with Accounting/Finance on reporting monthly revenue numbers, analyzing revenue drivers, and collections of Accounts Receivables.
• Maintains professional relationships and collaborates across teams, managing projects, facilitating meetings and presenting in various settings, including to executive leadership.

Skills on Resume: 

• Revenue Optimization (Hard Skills)  
• Contract Management (Hard Skills)  
• Process Improvement (Hard Skills)  
• Data Management (Hard Skills)  
• ROI Analysis (Hard Skills)  
• Claims Analysis (Hard Skills)  
• Regulatory Compliance (Hard Skills)  
• Stakeholder Collaboration (Soft Skills)