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Director Of Revenue Cycle Management

Company: Balboa United
Location: San Diego
Posted on: September 17, 2020

Job Description:

Do you want to work in fast paced medical group that continues to grow year over year? Do you have experience in a large medical practice with hundreds of payors and multiple divisions? Do you have experience with California billing and payor markets? Then keep reading! OverviewThe Director of Revenue Cycle Management, reporting directly to the Chief Financial Officer, oversees the entire revenue cycle function within the organization. This individual will direct, manage, and implement programs to ensure efficient operations of the billing & collections revenue cycle using sound business principles compliant with all billing, collections, cash management, payment posting, pre-registration, charge capture and compliance regulations. Extensive knowledge of California billing and payor markets is required to be successful in this role.--Essential Duties and ResponsibilitiesIdentify, analyze, reduce and resolve all revenue cycle issuesProvide day-to-day management of all revenue cycle staff, including recruitment, performance management, scheduling, disciplinary actions, training and development and other duties as necessaryKeep abreast of all healthcare changes and third-party payer regulations to identify updates to support compliance; periodically review, update and/or create policies and proceduresMaintain open, ongoing communication with MD's, clinics, payers, vendors, etc. and promote a positive customer service environment.Collaborates with COO/CFO on Health Plan/Payer contract review, negotiation and adherenceEnsures timely charge capture from all BNMG providers for all office, hospital and dialysis visits.Timely management of monthly global dialysis charges to include verification of MCP, partial month or home codes. Identification of MD's/NP's consistently not completing a full MCP with full treatment month.Diligently manages A/R throughout the month by keeping days in A/R within industry standard; completes monthly trend analysis of A/R.Monitors accuracy of payment posting, EOB's and denialsReviews all denials and resolution; consistently sends out patient statements; identifies accounts that need to be sent to collections; reviews credit balance reports and process refund checks according to policy. Monitors low payments and resolution of outstanding balancesDetailed working knowledge of Medicare and requirements for successful claims submission and payment expectationsOther duties and tasks as assignedRequired Qualifications Minimum Education: Bachelor's Degree in business administration/finance, management, accounting, or similar; at least 5 years applicable experience may be substitutedMinimum 7 years' experience medical billing & revenue cycle managementAdvanced knowledge of CPT, ICD-10, HIPAA, EHR, Billing, Government payer codesExtensive knowledge of California billing and payor marketsExperience in a large medical practice or medical groupStrong computer skills to include Microsoft Suite; advanced knowledge of Microsoft ExcelExperience using Electronic Medical Record systemExperience managing and leading a departmentExperience analyzing data, solving issues as they arise, and making recommendations for improvementPreferred QualificationsCPCExperience using EPIC electronic medical record system

Keywords: Balboa United, San Diego , Director Of Revenue Cycle Management, Executive , San Diego, California

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