Revenue Cycle Director jobs in Minnesota

Kai Shin Clinic seeks a Revenue Cycle Director with 5-10 years experience as a revenue director in behavioral health ideally, MUST be in medical field, 5 years experience as a revenue manager, and 5 years experience as a biller. This person will oversee the revenue cycle from start to finish, and will help as we grow across state lines. We have brought the billing in house, and we are working on increasing collections, refining the SOPs, improving reports, and month end close. The director should be comfortable with cross team collaboration, and being able to help educate and improve knowledge across the company. They will be asked to assist with training the managers of other departments to ensure they are able to properly train the new hires and their team members. This is a growing enterprise, experience with a fast growing company desired.

College degree preferred but not required. We use advancedMD and procentive software. There are two billing components, medical/mental health billing and substance use disorder billing. We seek someone to grow with us and become part of the management team. You will also be overseeing some business office functions.

Full Job Description

The Revenue Cycle Director reports to the ownership team and is responsible for overseeing and coordinating all revenue cycle activities with a goal of maximizing reimbursement in a cost-effective manner that is in compliance with federal, state and payer-specific billing requirements. The Director will oversee the overall policies, objectives, and initiatives of our client healthcare facilities' revenue cycle activities to optimize the patient financial interaction along the care continuum.

Required Qualifications:

● Experience in Healthcare Administration, Business, Accounting, Finance or related field and three years of management-level experience in Multi Specialty revenue cycle with expertise in billing and collections.

● Thorough knowledge of patient financial services (PFS) processes and standards related to billing, collections, and cash posting. General knowledge of patient registration, finance, and data processing.

● Knowledge of regulatory requirements related to patient accounting, including a solid understanding of Medicare, Medicaid and managed care processes.

● Ability to work and communicate effectively with a diverse group of people including other department managers, staff, physicians, patients, and the public.

● Ability to read, analyze and interpret financial reports, contracts, and other legal documents.

● Outstanding ability to work independently to achieve results. Often, there is no precedent for and little help in carrying out assigned tasks. Must originate, plan, adapt and invent to accomplish tasks.

● Ability to set and maintain priorities when dealing with multiple demands and interruptions.

● Strong analytical and problem-solving skills.
● Dedication to the development of others and willingness to coach and mentor people as necessary to promote their personal and professional growth.
● Excellent customer service skills.
● Intermediate computer skills including email, word processing, spreadsheets, and working with graphics.
● Must be able to do medical credentialing

Duties and Responsibilities:

● Oversee and support the daily operations of all PFS functions, including billing, follow-up and collections, cash posting etc.

● Work closely with clients and internal departments to streamline procedures that will help ensure correct billing to patients and payers in a timely manner, thereby expediting receivables.

● Oversee work schedule and direct changes in priorities and schedules as needed to assure work is completed in an efficient and timely manner and to improve the department’s performance and service.

● Direct the selection, supervision and evaluation of staff. Ensure performance evaluations are conducted in a timely manner according to company policy and initiate disciplinary actions as warranted. Resolve grievances and other sensitive personnel matters.

● Oversee orientation and continuing education for all staff. Ensure mandatory and relevant training is provided to staff in a timely manner.

● Implement a Quality Assurance program for all RCM functions and monitor staff and team performance, making changes, when required, to support accurate billing to payers and patients in a timely manner and compliance with laws and department procedures.

● Establish and maintain departmental policies and procedures. Communicate relevant information to other departments. Establish controls and review

mechanisms to ensure procedures are being followed correctly. Recommend policy changes to the Chief Financial Officer.

● Collaborate with Billing, Collection, and Patient Access Managers to plan, organize, and deliver regular staff meetings for the department.

● Assist with the development of budgets and monitoring of department operations to achieve goals within budget.

● Ensure compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers.

● Maintain appropriate internal controls for the safeguarding of information.
● Follow and monitor compliance with hospital policies and standards.
● Develop, redesign, and monitor key performance indicators including payer mix,

A/R, collection rates, adjustments, bad debt write off, estimated collections, appeal success rates, and other requested parameters.

● Maintains extensive knowledge of revenue cycle and regulatory requirements associated with governmental, managed care, and commercial payers.

● Serves as the subject-matter expert on regulatory, compliance, and legal requirements associated with medical billing and CMS. Ensures compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers.

● Develops and maintains internal controls to target revenue recovery throughout the organization by identifying charge capture, coding, and reimbursement problems, then recommending/implanting solutions.

● Monitor A/R effectively and ensure aging categories are within established goals and national benchmarks.

● Responsible for maximizing the collection of medical services payments and reimbursements from patients, insurance carriers, financial aide, and guarantors.

● In conjunction with operations, reviews and enhances insurance verification, coding review, billing, collection, and payment posting processes for efficiency and best practices; ensure systems are fully functional and maximized and recommend new processes to improve current work flow.

● Monitors daily productions of claims, denials, and appeals.
● Analyzes claims, utilization, and medical cost data.
● Monitors aged accounts and verifies appropriate collections procedures are being followed.
● Reviews, monitors and recommends updates to the Clinic’s fee schedule to maintain fees at levels that maximize reimbursement.
● Ensures compliance with relevant federal, state, and payor-specific billing requirements.
● Regularly provides upper management with revenue cycle status including reports, metrics, and presentation.

● Ensure staff is educated on new technology, goals, and contracts
● Establish a regularly scheduled revenue cycle meeting to discuss strategies and ensure everyone is educated on the direction of the department.
● Work with Managed Care vendors in identifying any payer relation issues or contracts that need to be renegotiated or negotiated for the first time.
● Any and all other projects, goals, issues surrounding the revenue cycle, conflicts or concerns as directed or indicated by Administration.

Job Type: Full-time

Job Type: Full-time

Pay: $90,000.00 - $110,000.00 per year

Benefits:

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

Healthcare setting:

• Clinic
• Outpatient

Medical specialties:

• Addiction Medicine
• Primary Care
• Psychiatry

Schedule:

• 8 hour shift
• Monday to Friday
• Weekends as needed

Ability to Commute:

• Saint Paul, MN 55114 (Preferred)

Ability to Relocate:

• Saint Paul, MN 55114: Relocate before starting work (Preferred)

Work Location: Hybrid remote in Saint Paul, MN 55114