Director of Revenue Cycle Management

Benefits

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off

The Director of Billing holds operational accountability over Ellie's billing account management function, providing leadership, organization, planning, and direction to the Revenue Cycle Performance Leads who serve as liaisons between the Billery and Ellie's franchise practice partners. This role contributes to the overall organizational and financial health by evaluating metrics and performance by franchisee, presenting the health of the revenue cycle, and delivering comprehensive reporting to franchise owners and Clinical Directors on relevant trends, KPIs, and insights.

The Director utilizes data mining and interpretation to develop solutions, support business-critical systems, design and implement best-practice workflows, and proactively audit revenue cycle outcomes. Partnering closely with leaders and teams across the continuum of care, this position streamlines processes, explains drivers and variances, and identifies opportunities for improved client, provider, and financial outcomes.

The Director of Billing leads by example, serving as a point of contact for escalated issues and supporting company-wide initiatives related to strategic priorities, healthcare regulation and compliance, system redesign, integrations, revenue optimization, and cost reduction.

Primary Responsibilities

• Responsible for alignment of the organizational goals of the team with franchisee service level expectations.
• Assists with development and implementation of the department's vision and strategies.
• Works to ensure the team performs with a collaborative approach while constantly striving to eliminate inefficiencies, improve client and provider satisfaction, and improve departmental systems via the use of continuous improvement tools and methodologies.
• Develops policies and procedures for managing a portfolio of franchisees for greater efficiency, lean management, best practices, optimal KPI's, reduced variation, and increased client satisfaction.
• Works cross-functionally with Client Access Team, Franchise Owners, Providers, and Clinic Operations to improve systems across the continuum.
• Prepares and delivers to VP weekly/monthly reports by franchise, including KPIs performance.
• Oversees hiring, development, and management of the team.
  • Implements performance standards, evaluates performance, and facilitates engagement within the team.
  • Develops performance and training goals and objectives for individual team members.
  • Provide timely and effective feedback and support that fosters self-improvement and teamwork.
  • Determines division of responsibilities and provides work guidance and direction.
  • Hold regular meetings with staff to review issues, reports, work expectations, and provide updates.
  • Supports communication of policy changes and updates with the team
• Collaborates with RCM leadership and functional managers to ensure service quality for our franchises
• Monitors A/R, large outstanding payer and patient balances, month-end reports, and collections, for escalated franchisees that need leadership involvement.
• Identify claim denial trends, communicate with appropriate staff, and coordinate projects to respond to franchisee inquiries and concerns about the health of their revenue cycle.
• Stay up to date with current coding, billing, payer requirements, and federal and state regulations related to billing and collections.
• Other duties as assigned or required

Competencies (Knowledge, Skills, & Abilities)

• Strong knowledge of CMS/Medicare/Medicaid/Commercial insurance rules and conventions
• Qualified knowledge of principles and practices, planning, and management essential to manage and coordinate the functions of billing and reimbursement.
• Competency in ICD-10-CM and CPT Coding principles and guidelines.
• Knowledge of AAPC standards of medical billing and coding a plus.
• Proficient knowledge of management software and applications.
• Strong understanding of healthcare compliance and HIPAA regulations.
• Preferred experience using Valant practice management software.
• Strong experience with Microsoft Office, including Word, PowerPoint, Excel, and Outlook.
• Proven ability to exercise a high degree of initiative, judgment, discretion, and decision-making.
• Demonstrated experience in financial analysis and reporting.
• Demonstrated expertise in gathering and interpreting data, investigating situations, and taking appropriate action.
• Ability to work collaboratively with all levels and across organization functions.
• Demonstrates awareness, inclusivity, sensitivity, humility, and experience in working with individuals from diverse ethnic backgrounds, socioeconomic statuses, sexual orientations, gender identities, and other various aspects of culture.

Education and Experience

• Bachelor's degree
• Ten years of revenue cycle experience in a leadership position.
• Minimum of Ten years of medical billing management experience in a clinic setting required with practical experience to include billing, reimbursement and denials management, and data reporting.
• Accomplished in managing a team of middle to backend revenue cycle team members.
• Experience in behavioral or mental health revenue cycle preferred.

Physical Demands and Work Environment

• Consistently uses a computer and/or other office equipment.
• Consistently uses a variety of computer applications, including video calls
• Simultaneously communicates over the phone while using computer applications
• Must be able to remain in a stationary position 50% of the time.
• Occasionally lift up to 10 pounds for office needs.
• Minimally required to stoop, kneel, crouch, or crawl.
• The ability to communicate information and ideas so others will understand. Must be able to exchange accurate information in these situations.
• Occasionally move or walk within an office environment.
• May occasionally need to climb stairs within an office environment.
• 0-25% - Travel is expected

Note

This job description in no way states or implies that these are the only duties to be performed by the employee(s) of this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities.

Flexible work from home options available.