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Position Summary The Director of Revenue Cycle is responsible for direction of operational functions of the revenue cycle. Leads initiatives to improve billing, collections, and other processes. Analyze revenue cycle metrics to ensure compliance with regulations and best practices. Creates and implements strategies to improve revenue cycle performance and performance improvement initiatives. Provides oversight of the functional areas (Business Office, Credentialing) that support the organization’s financial and operational goals. Works closely with stakeholders to coordinate activities of the Revenue Cycle across the organization. Ensures compliance with CMS regulations, company policies, and standards for third party payers. Fosters and promotes a culture of excellence in customer service to internal and external clients. Builds trust and collaboration amongst the team by enhancing employee engagement, addressing performance results, and providing coaching and mentoring. Essential Duties and Responsibilities include the following:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Other duties may be assigned. Oversight for Claims Management, Billing, Accounts Receivable Management, Revenue Cycle Systems Analyst, Business Office, and Credentialing. Overseeing and managing daily operations of the revenue cycle vendor to meet financial goals. Partner with vendor to establish agreed upon service level metrics and holding them accountable for meeting them. Analyzing revenue cycle data to track key performance indicators (KPIs), identify areas for improvement, and potential revenue leaks or inefficiencies. Identifying and resolving issues that affect revenue cycle performance using analytical and problem-solving skills. Implementing strategies to accelerate the revenue cycle by reducing accounts receivable days and write offs to improve cash flow and enhance profitability. Denial management and analysis to reduce controllable denials. Overseeing the deposit and reconciliation processes within the Cashiers Office. Collaborating with cross-functional teams to ensure the effectiveness of the revenue cycle process. Developing and implementing policies and procedures to enhance operational efficiency and improve revenue cycle performance. Identifying opportunities to streamline revenue cycle processes, implementing new technologies, and optimizing workflows for efficiency. Ensure EDI standards for electronic claims submission. Investigate errors generated from electronic claims submission by working closely with technical teams to troubleshoot claims processing issues. Maximizing the use of EPIC functionality. Consistently providing opportunities to enhance workflows. Collaborate with IT teams on system configurations and upgrades. Provide leadership and direction to the Revenue Cycle Systems Analyst. Plan, establish and administer procedures for conducting daily MFA credentialing services in accordance with policy guidelines and overall needs of the MFA. Oversee the roles and responsibilities for delegated credentialing and payer enrollment. Minimum Qualifications The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education Bachelor’s Degree in Business/Healthcare Administration and/or equivalent combination of relevant work experience. Experience Minimum of 10 years’ experience in a large academic group practice with emphasis on back-office functions (claims submission, A/R follow-up, customer service, and cash services). Comprehensive knowledge of claims management, HIPAA standards, CMS requirements, managed care, CPT, and HCPS coding. Knowledge in healthcare compliance including privacy and security regulations, confidentiality laws, access and release of information. Strong organizational skills with the ability to work on multiple, complex projects with high quality results. Excellent verbal, written and attentive listening communication skills. Must have ability to form working relationships with individuals at all levels of the organization. Strong positive interpersonal skills to collaborate with Senior Management, Physicians, and Executive level staff. Excellent analytical skills including the ability to analyze quantitative and qualitative information and reach sound conclusions. Ability to perform A/R statistical analysis, identify gaps, develop solutions and implement necessary changes for the achievement of key metrics (Days in A/R, aged receivable greater than 90 days, denial rate, bad debt percentage, and collection rate). Proficient with MS Office suite especially EXCEL and leveraging this tool to complete analyses. Knowledge of medical terminology, classification systems, and vocabulary. Ability to maintain a professional demeanor and confidentiality is required. Competencies Ability to input data into the computer, and analyze data as requested. Must be able to communicate providing verbal feedback in a professional manner. Must be able to follow and understand instructions and react favorably in all work situations. Must be mentally adaptable and flexible in dealing with a variety of people. Supervision Received Supervision received from Senior Director, Revenue Cycle. Supervision Exercised Supervision over Business Office and Credentialing staff. Typical Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Frequent mobility and/or sitting required for extended periods of time. Requires manual dexterity to operate computer keyboard, calculator, copier machine, and other equipment. Working Conditions The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

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