Director, RCM

Company: Foundation Radiology Group
Location: Pittsburgh
Posted on: September 16, 2020

Job Description:

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Director, RCM Full-time Regular Pittsburgh, PA, US

17 days ago Requisition ID: 1073

POSITION SUMMARY:

The Director of RCM has direct oversight of the internal and external billing and collection operations. The incumbent is expected to work closely with the Manager of RCM, RCM Analyst, and Credentialing team to ensure accurate, compliant and timely billing in an effort to maximize cash collections through optimization of RCM processes, renegotiation of payor contracts and participation in payor incentive programs. It is also the responsibility of the incumbent to align and optimize RCM through proactively managing and setting process improvement initiatives with our third party billing provider. The incumbent is expected to act independently and exercise judgment regularly consulting the CFO when appropriate.

ESSENTIAL FUNCTIONS AND ACCOUNTABILITIES:

Work with the billing contractor to ensure the timely, complete and accurate transfer of billing data from treatment sites to the billing company.

Proactively manages and fosters a working relationship with our billing contractor to ensure RCM is being optimized and continues a process of improvement.

Establish and monitor reconciliation processes to ensure that all eligible services are captured and billed.

Conduct or oversee routine coding audits to ensure accurate and compliant diagnosis and procedure codes utilization.

Establish and monitor audit processes to ensure that billed procedures are being paid in accordance with governmental and negotiated contract allowances.

Establish with the CFO billing Key Performance Indicators, monitor actual performance to established benchmarks, report progress to management, and work with the billing contractor to achieve desired outcomes.

Provide the CFO and management the standard and ad hoc reports required to manage the organization successfully.

As a member of the management team, communicate and coordinate effectively with the various managers in support of organization’s goals and objectives.

Troubleshoot and work with the billing contractor to resolve billing issues.

Foster a customer-centered organizational culture through professional and efficient service to practice management and staff and the billing contractor.

Ensure compliance with rules and regulations surrounding the documentation and billing of professional services

Provide supervision to the Manager, RCM & RCM Analyst.

Promotes positive employee relations and works effectively with HR to ensure a harassment free environment.

In performance of all duties, acts in accordance with the company’s mission, vision and values

Adheres to the company’s code of conduct.

Handle other duties and special projects as assigned.

MINIMUM QUALIFICATIONS REQUIRED:

Education:  Bachelor’s degree in accounting, healthcare or business administration is required. Master’s degree in related field is preferred. Combination of education and experience is acceptable and will be considered.

Experience:   Minimum of five (5) years of relevant work experience in the field of health care revenue cycle; includes patient financial services, patient access or other revenue cycle work. Progressive managerial experience highly desired.

Knowledge, Skills & Abilities:

Ability to direct, control, and supervise the revenue cycle operations

Proficient with computer systems capabilities and procedures

Excellent interpersonal skills are required to train and supervise personnel

Must possess analytical and problem-solving skills and ability to effectively communicate and work with both public and staff

Ability to analyze information and prioritize various tasks in a fast paced environment

Advanced working knowledge of Medicare, Medicaid and third-party Payers system

Strong values, ethics and integrity, proven decision making ability

Possess well developed skills in effectively interacting with physicians, executives, peers and cross-functional teams.

Certification/Licensure:  None

TYPICAL PHYSICAL DEMANDS/WORKING CONDITIONS: Refer to Working Conditions and Physical Demands for Office Personnel with Travel.

Keywords: Foundation Radiology Group, Pittsburgh , Director, RCM, Other , Pittsburgh, Pennsylvania