Job #1683: Director of Revenue Cycle Management- Iselin, NJ (9-2-21)
Job TitleDirector of Revenue Cycle Management
EisnerAmper is conducting a search for their client, for a Director of Revenue Cycle Management (RCM), responsible for oversight of the Central Business Office (CBO). The CBO services all locations providing short-term/long-term and private duty care in multiple states. This individual will be responsible for directing and coordinating the overall functions of the CBO to ensure maximization of cash flow while improving patient, caregiver and other customer relations.
Within the CBO, the Director will be responsible for oversight of the following RCM processes and its respective staff members: 1) Authorization, 2) Eligibility, 3) Billing, 4) Rejection and Denial Management, 4) Payment Posting and 5) Accounts Receivable (payer, contract and self-pay).
- Manage and supervise the day to day operations within the CBO
- Supervises, trains, orients and evaluates performance of assigned team members
- Monitors daily operating activity of respective department and makes necessary adjustments in work assignments.
- Oversight of authorization follow-up and management team from participating payer contracts
- Oversight of recurring patient insurance eligibility review and management to ensure accurate active insurance information
- Reviewing of Authorization for all contracts to ensure that there are no visits missing authorization
- Directly supervises front end and accounts receivable collection team. Monitors progress of team on a daily basis and re-directs follow up efforts as appropriate.
- Enter rate changes within a day of receipt
- Provide pre-billing support and feedback on held/unbilled claims in conjunction with the Coordination, Authorization and Payroll department to expedite payroll and claims release
- Review split shifts to ensure entire shifts are billed and caregivers are being paid correctly
- Completed billed not exported claims review and release claims for billing according to payer contract standards and organization bill-runs
- Complete review of all pre-billing reports by 24-48 hours prior to weekly billing
- Review pre-billing for overlapping shifts all assigned contracts and make corrections as needed
- Complete review of payroll/billing reconciliation
- Ensure staff completes/provide back-up to staff for invoicing of all contracts by Wednesday PM on a recurring weekly basis
- Complete upload of all electronic contracts and emailing/submission of paper claims per payer/direct contracting designated timeframes
- Review clearing house rejections daily, trouble shoot and resubmit
- Ensure all billing rates are accurately reflected on billing system and spreadsheet are all updated upon receipt of amendments
- Complete adjustment and resubmissions of credit and rebills within one week of identification/request.
- Responsible for ensuring receivables over 90 days are collected timely
- Maintains an itemized billing record each month for each client that indicates the services provided
- Receives payments/reimbursements and posts them to the accounts receivable ledger
- Reviews all payments/reimbursement reports for accuracy; identifies errors and corrects errors prior to re-submitting to the payer
- Corrects all returned or denied billings prior to re-submitting to payer
- Communicates with payers when necessary to facilitate reimbursement.
- Review AR and follow up with the team to ensure rate adjustments, corrected claims and write offs are completed weekly and prior to month end closing
- Attends administrative meetings and participates in committees as requested. Conducts special projects and studies as directed
- Participates in professional development activities and maintains professional affiliations.
- Maintains confidentiality as regards patient account status
- Assist with any other job functions within Billing Department as needed
- Knowledge of Medicare/Medicaid (MCO, MLTC, other payer types, etc.), home care benefits, rules and regulations
- Excellent organizational, interpersonal skills and communication skills required
- Ability to work with various computer and data entry systems, including Microsoft Office (Word, Excel, PowerPoint), computer systems and other database software.
- Demonstrated ability to supervise and lead billing/collections team.
- Must be a team player and can work effectively with people of diverse cultures and backgrounds in a fast pace environment.
- Demonstrates good communication skills.
- Detail oriented and excellent self-initiative.
- 10 years directly related and progressive health care revenue cycle experience will be considered in lieu of a degree. With degree, minimum 5 years medical business office experience, with 3-5 years as a department manager in billing, accounting or information systems.
- Patient billing management software
- Exceptional attention to detail and accuracy
- Knowledge of current ICD and CPT guidelines
- Excellent written and oral communication skills
- Ability to shift priorities; superior problem-solving capabilities
- Persuasive, encouraging, and able to motivate others
- Ability to effectively prioritize and execute tasks in a high-pressure environment
Bachelor’s degree in business administration or related field; Master’s degree preferred.
Interested candidates should e-mail resume to firstname.lastname@example.org at Dianna Sapozhnikov. Please mention that you are a member of EisnerAmper's Friends of the Firm program. Make sure to include Job #1683 in the subject line and to copy email@example.com on your email.