Category: Accounting & Finance
100000.00 - 150000.00
Director, Revenue Cycle Management wanted for rapidly growing company in So. Plainfield!
Purpose of the Position:
Responsible for management and support of enterprise-wide revenue cycle for billing and reimbursement. Compliance officer responsible for ensuring full Federal and State Compliance.
- Directs and oversees the overall policies, objectives, and initiatives of the organization’s revenue cycle activities to optimize reimbursement and ensure compliance
- Works with upper management/leadership team regularly to discuss plans of action, issues,best practices, and compliance
- Assesses and makes recommendations to improve efficiency of current systems/processes for the entire Revenue Cycle
- Be the main contact point as it pertains to any revenue cycle management questions, concerns,updates.
- Prepare monthly revenue cycle reports
- Manages the internal billing staff
- Reviews, designs, and implements processes surrounding billing, pricing, third party pay relations, compliance, collections and other financial analyses to ensure that revenue cycle is effective and properly utilized
- Identify and analyze reimbursement trends to advise Upper Management and internal stakeholders accordingly
- Perform prospective and retrospective chart audits, reviewing for accuracy and compliance
- Work closely with billing vendor and reimbursement staff to address billing issues and streamline workflows
- Work closely with Internal and External Sales Groups to ensure proper guidelines are followed and ensure any questions or concerns as they relate to billing and reimbursement are handled in a timely and efficient manner
- Investigate billing issues due to potentially inappropriate documentation, coding, and/or medical necessity
- Follow up with the referring physician offices and/or Internal/External Sales Groups to ensure corrective actions are taken
- Investigate, evaluate, recommend, and implement coding and fee updates
- Negotiate contracts with payers based on needs of the company
- Perform other administrative and supervisory duties as assigned
- Bachelor’s Degree or relevant experience required
- Coding certification required
- 10+ years’ experience Staff Management
- 10+ years’ experience hands on billing & coding required
- Strong understanding of the Revenue Cycle and ability to manage each aspect of it
- Compliance Officer experience a plus
- Experience in a molecular / genomics lab highly preferred
- Audit Certificate highly preferred
- Strong understanding of the Medical/Laboratory Billing Process and Industry Standard
- Exceptional Knowledge of ICD’s, CPT’s, and LCD’s.
- Must possess strong knowledge of EOB’s and ERA’s with the ability to read and understand the follow-up steps required to mitigate any issues that need attention
- Successful track record of negotiating with insurance companies to be brought in-network
- Highly proficient in Microsoft Office, specifically Excel
- Excellent interpersonal, verbal, and written communication skills
- Ability to multitask and manage several projects concurrently
- Ability to think outside the box
Excellent benefits package!