MD EyeCare Services Corporate

Director of Revenue Cycle Management

US-TX-Dallas
3 weeks ago
Job ID
2017-1931
# of Openings
1
Category
EyeCare Services Partners
Type
Regular Full-Time

Overview

The Director, Revenue Cycle Management will maintain and support the professional services and billing platform for EyeCare Services Partners Management LLC (ESP) and will have responsibility for payment posting, billing and collecting all clinical activities/revenue. The Director, Revenue Cycle Management, will also ensure all facilities are utilizing standard operating procedures that result in accurate billing and timely collections while creating systems and processes that monitor and manage collections and compliance with payer and other regulatory bodies.

 

The Director, Revenue Cycle Management will have an opportunity to grow with ESP – as the business grows, there will be additional Regional Business Offices that the Director will oversee and transition into ESP standards and performance.  The Director, Revenue Cycle Management will be expected to travel to and spend time in each of the locations they are assigned.  This position requires a highly motivated, productive and experienced billing professional with a desire to start on the ground floor of a dynamic and fast-paced organization.

 

Responsibilities

  • Maintain standardized billing department policies and procedures and comply with SOP’s that ensure maximum collections and regulatory compliance, acting as a liaison among accounting, billing, operations and clinical staff.
  • Perform analytical reviews and quality assurance on all data generated by Billing and Collection Department to ensure data integrity.
  • Work closely with Operations team to communicate information necessary to ensure efficient processes are understood and implemented in accordance with policies and procedures. Examples would be Denial Management reports to reduce front office errors that slow receiving of payments.
  • Ensure proper billing and collections relating to commercial and government reimbursement.
  • Responsibility for regulatory compliance and credentialing as it relates to payer transactions as well as HIPAA and PHI regulations.
  • Responsible for accurate and timely billing, data entry, charge corrections, payment entry, adjustments, invoice corrections, pre-registration and collections.
  • Works closely with the Implementation team to ensure a smooth transition for start-up and newly acquired locations and to ensure uninterrupted cash flows and billing processes.
  • Manage third-party audits with excellent outcomes and learning that drive functional improvements to SOP’s.
  • Third party claim resolution processes including denials and appeals management.
  • Generate and distribute billing metrics for dissemination to the Providers, facility staff, Operations Team and Corporate Services Team.
  • Considers company budget goals in assessing expenditures for reimbursement management; fiscally prudent.
  • Review adjustments to receivables. Develop action plans to reduce avoidable adjustments.
  • Review reimbursement levels to determine when changes take place and keep abreast of changes in the industry that will impact charging patterns and reimbursement levels.
  • Follows Red Flag Policy and Procedures

Qualifications

  • Bachelor’s degree in Business Administration, Accounting, Finance or commensurate experience in healthcare industry.  Master’s degree preferred.
  • Must have 5-8 years of progressive work experience in revenue cycle, Patient Accounts, Accounts Receivables, Payment Posting, Claims Processing and Denial Management.
  • Must have 5 years of management experience in Revenue Cycle.
  • Strategic thinking skills. The appropriate candidate will be able to see the strategic organizational goals and provide input so that each market is developing and growing as ESP grows and changes.
  • Desire to work in a fast paced environment.
  • Team development skills and associate engagement skills
  • Prefer experience with AR’s of $20 million or greater
  • Thorough knowledge of Microsoft Excel and other billing system platforms is necessary.
  • Understanding of medical coding systems. These include ICD-10, CPT, HCPCS, APG, APC, and revenue code structures.
  • Advanced financial analysis skills including strong analytical capability with knowledge of accounting principles and statistical analyses.
  • Knowledge of industry reimbursement methodologies.
  • Must be able to identify root causes and prioritize corrective actions.

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