Revenue Cycle Management:
- Oversee the end-to-end revenue cycle process, including charge billing, claims submission, denial management, and general accounts receivable.
Operational Excellence:
- Continuously evaluate and optimize billing processes, workflows, and technologies to improve efficiency, reduce denials, and maximize revenue capture.
Compliance and Regulatory Oversight:
- Ensure compliance with relevant healthcare regulations, and payer requirements to mitigate risks and maintain accurate and ethical billing practices.
Financial Performance:
- Monitor key performance indicators (KPIs), revenue metrics, and financial trends related to AR operations. Implement strategies to achieve revenue targets, reduce days in accounts receivable, and improve cash collections.
Team Leadership and Development:
- Recruit, train, and manage a high-performing AR team. Foster a culture of collaboration, continuous learning, and professional development to optimize team performance.
Stakeholder Collaboration:
- Partner with internal stakeholders, including finance, operations, human resources, compliance, and IT departments, to drive cross-functional initiatives, implement process improvements, and enhance revenue cycle performance.
Industry Knowledge and Trends:
- Stay abreast of changes in healthcare regulations, reimbursement methodologies, and industry best practices related to billing. Apply this knowledge to inform strategic decisions and identify opportunities for improvement.
Education and Experience Requirements
- Bachelor s degree or Masters and experience in related field preferred.
- At least (10) years of AR experience preferred.
- At least (4) years of supervisory / management / leadership experience preferred.
- In-depth knowledge of billing and coding principles, healthcare reimbursement methodologies, and regulatory requirements (e.g., HIPAA, Medicare, Medicaid, commercial payers).
- Strong understanding of revenue cycle management processes, including charge capture, claims submission, denial management, accounts receivable, and payment posting.
- Familiarity with billing software, practice management systems, and electronic health record (EHR) platforms commonly used in physician billing.
- Demonstrated ability to analyze financial data, identify trends, and implement strategies to optimize revenue cycle performance.
- Excellent leadership, communication, and interpersonal skills, with the ability to collaborate effectively with diverse stakeholders.
- Strong problem-solving abilities, attention to detail, and the capacity to work in a fast-paced, deadline-driven environment.
- Knowledge of healthcare industry trends, emerging technologies, and regulatory changes impacting physician billing.
- Experience in managing teams and leading change initiatives within a healthcare organization.
- Experience with mergers and acquisitions is highly desirable.
Knowledge, Skills, and Abilities
- Ability to read, understand, and apply state/federal laws, regulations, and policies.
- Ability to communicate with diverse personalities in a tactful, mature, and professional manner.
- Ability to remain flexible and work within a collaborative and fast paced environment.
- Basic use of computer, telephone, internet, copier, fax, and scanner.
- Basic touch 10 key skills.
- Basic Math skills.
- Understand and comply with company policies and procedures.
- Strong oral, written, and interpersonal communication skills.
- Strong time management and organizational skills.
- Strong knowledge of Outlook, Word, Excel (pivot tables), and database software skills.
Physical Demands:
- Office environment with occasional travel for training and audits.
- Flexible working hours may be required to meet project deadlines.
