Tallahassee Orthopedic Clinic
  • - Revenue Cycle Director
  • Tallahassee, FL, USA
  • $70,000 - $110,000
  • Salary
  • Full Time
  • Medical, Dental, Supplemental, PTO, Paid Holidays, Group Life, 401k

We are currently seeking a Director for overseeing revenue cycle management including coding, billing, collections, and denial management.  Applicant must have a thorough understanding of the entire revenue cycle process and provide leadership as well as partner with other leaders within the organization. This position will drive performance improvement and revenue enhancement opportunities, and as a subject matter expert they will assist in providing strategy, decision support, organization planning, and operational leadership to optimize productivity, quality and overall company revenue.   The Revenue Cycle Director will provide direct supervision to two Supervisors on the Revenue Cycle team (who oversee all billers, coders, claim creation and other administrative team members) with a dotted line to the credentialling team. Supervision responsibilities to include development opportunities, training and mentorship. The Revenue Cycle Director will minimize bad debt, improve cash flow, and effectively manage accounts receivables. The Revenue Cycle Director is also responsible for various reporting within the organization.  This position is to stay apprised of coding and revenue trends; and is responsible for coding education to clinical and coding/billing staff.

Work is conducted remotely, outside of a traditional office environment.  Appliant must be able to perform work at a dedicated work space with limited interruption or distraction, and high speed internet capacity with 25 Mbps download speed/10 Mbps upload speed.

Essential Functions:

  • Oversee and manage entire revenue cycle including billing, coding, collections, and denial management.
  • Manage, develop, and mentor all revenue department staff, including billers and coders and RCM Supervisors.
  • Provide up to date education for clinical, billing, and coding staff on coding trends.
  • Develop, evaluate, implement, and revise policies and procedures related to billing, coding, reimbursement activities and improvement strategies.
  • Reconcile all receivables and revenue reports and work closely with the finance department in the development of monthly financial reports.
  • Conduct monthly analysis of Medicare/Medicaid/Third Party Payers to identify trends.
  • Establish annual financial goals and uses benchmarking to high performing systems to set annual targets in collaboration with the CFO.
  • Generate and manage revenue, productivity and metric reports.
  • Prepare and deliver reports regarding goals and objectives.
  • Review and resolve issues related to claim generation and rejected/denied billings.
  • Liaison with corporate team that oversees the processing of credentialing and provider enrollment applications, initial, and re-enrollment status with all Medicaid, Medicare, and Commercial Payors.
  • Serve as a liaison within the company among departments and interact with outside vendors for the benefit of the organization. 
  • Commit to highest level of business and patient confidentiality possible adhering to all HIPAA and security guidelines when accessing and sharing patient information.
  • Technical expert for Athena billing processes.
  • Stay abreast of all reimbursement billing procedures of third party and private insurance payers and government regulations.
  • Monitor accounts sent for collection and reimbursement from insurance companies and other third-party payers.
  • Review, monitor, and evaluate third party reimbursement and researches variances.
  • Participate in the development of coding and billing strategies, evaluating process relative to revenue cycle, and make recommendations while ensuring compliance with any relevant rules or regulations (including HIPAA, Medicaid, Medicare, and specific 3rd Party Payors).
  • Actively seek opportunities to improve financial outcomes.
  • Monitor and analyze financial data and utilize same for decisions regarding FTE's staffing and workflow.
  • Create business plan(s), justifying variances and analyzing cost benefit of programs.
  • Contribute to the success of TOC by providing leadership, direction and coordination of operations, finances and human resources for area of responsibility.

 

General Competencies:  

  • Knowledge of third-party payer requirements including federal, state and private health care plans
  • Experience supervising a range of staff
  • A self-directed individual with sound technical skills, analytical ability and good judgment 
  • Intelligent and articulate individual who can relate to people at all levels of an organization and possesses excellent communication skills.
  • A good educator who is trustworthy and willing to share information and serve as a mentor 
  • Excellent written and verbal communication skills, including the ability to read, analyze and interpret the most complex documents

Credentials:

  • Bachelor's degree in Accounting, Business or Health Administration or an equivalency of five years of related work experience.
  • CPC a plus.

 

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