Mid Atlantic Retina
  • Plymouth Meeting, PA, USA
  • Salary
  • Full Time

Job Description

The Revenue Cycle Director will oversee the insurance billing, coding, and collection policies as well as objectives and initiatives of the organization's billing activities. This candidate will understand the impact of revenue recognition and bad debt on the organization. This position will report directly to the Chief Financial Officer.

Essential Functions

  1. Develops a thorough understanding of systems, processes and payor specific reimbursement mechanisms and billing requirements, contributing in the proactive identification of opportunities for revenue cycle improvement and enhancement.
  2. Oversee and manage the performance and development of all billing managers, supervisors, and leads.
  3. Develops and executes action plans to insure timely collections and timely follow-up.
  4. Prepares analysis and uses data as a key driver to plan, organize, manage, and control collection processes.
  5. Provides direction and coordination for the development and implementation of performance and quality improvement processes for the physician revenue cycle.
  6. Monitors, reports, and collaborates with other departments to ensure timely and appropriate charge data entry and release of charges on hold.
  7. Analyzes data to identify trends related to denials and rejections; develops and executes plans to avoid, reduce, and resolve denials and rejections.
  8. Develops relationships with third party payors to address escalated issues.
  9. Manages the teams responsible for timely posting of cash receipts, including but not limited to third parties, patients, and facilities to patient accounts.
  10. Ensures proper and balanced delegation of work to billers and collectors.
  11. Ensures operational controls are in place to avoid unnecessary write offs.
  12. Organizes and plans improvements in clinically based denial resolutions strategies.
  13. Communicates group and organizational strategies and objectives. Contributes to associate development processes for assigned associates.
  14. Manages relationships with various consultants, vendors, and collections agencies that supports the collections process.
  15. Creatively uses technology and innovation to solve issues and improve processes.
  16. Directs and ensures timely completion of projects/work plans.
  17. Stay current on all managed care, Medicare, Medicaid, and other payor regulations that impact billing activities
  18. Performs other related duties as required and assigned.

Competencies

  1. Leadership - Inspires team members to improve, stretch and do more for the good of the team. Inspires others to become better leaders themselves.
  2. Communication & Relationship Management - Maintains open and interactive discussion with team and is aware of their needs.
  3. Professionalism - Develops individual relationships with coworkers and reports while maintaining work appropriate boundaries.
  4. Business Skills & Principles - Demonstrates understanding of practice management and staffing.
  5. Customer Service - Conflict resolution skills, responds promptly to customer needs.
  6. Project Management - Strong organization, multi-tasking skills with great attentiveness to detail. Ability to prioritize and delegate responsibilities.
  7. Technical Skills - Knowledge of health care and medical procedures, including terminology. Knowledge of vision/retina/ophthalmic terminology and procedures.  Subject matter expert in billing, coding and insurance.
  8. Problem Solving/Analysis - Identify and resolve problems and conflicts promptly.
  9. Ethical Conduct - Maintains confidentiality.
  10. Time Management - Maintains high volume productivity level for essential functions.

Supervisory Responsibility

This position has direct supervisory responsibilities, serves as a coach and mentor for other staff in the organization, and is part of the Leadership Team.

Work Environment

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

Work From Home:

Occasionally if work from home standards are met.

 

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

  1. While performing the duties of this job, the employee is regularly required to talk, communicate verbally in front of groups, one to one, over the telephone and in email.
  2. This is largely a sedentary role; however, some filing may be required. This would require the ability to lift files, bend and reach open filing cabinets and bend or stand on a stool as necessary.
  3. Listening to verbal communication using a telephone and processing the information while entering the data into a computer system, processing auditory information and responding verbally back in an appropriate manner.
  4. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus.
  5. Using hands to operate equipment such as a computer mouse, show manual or finger dexterity, handle things with precision or speed, use muscular coordination and physical stamina. 
  6. Following through on plans or instructions.
  7. Ability to use words to communicate ideas, reading with comprehension and explain abstract or complex ideas in terms that are more basic (ex:  explain the difference between Medicare & Medicaid.)
  8. Use senses to observe and pay attention to detail.  Ability to working with data and numbers, calculate and manipulate numbers, process data on a computer, attend to details, classify, record, store and retrieve information.
  9. Following through on plans or instructions.
  10. Using words to communicate ideas, reading with comprehension, writing reports or other documentation, teaching or training staff and others.

 

Position Type/Expected Hours of Work

This is a full-time position. Days and hours of work are Monday through Friday, 8:30 a.m. to 5 p.m. Occasional evening and weekend work may be required as job duties demand.

Travel

Travel is estimated to be 10% with advance notice for this position.

Required Education and Experience

  1. Bachelor's degree in health care administration, business or other related field OR equivalent experience required.
  2. Minimum of 5 years' experience in health care management, specific to the Revenue Cycle.
  3. Strong background in financial management and knowledgeable of federal and state laws and requirements relating to healthcare management.

EEO Statement

MAR is a proud Equal Opportunity Employer.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Mid Atlantic Retina
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