Job Purpose
The Clinical Revenue Cycle Director will oversee the operational structure and implementation of the Denial Management client service operational requirements, responding to the client and business needs impacting the performance of the Division’s work product. This position will define and manage process review related to improving operational outcomes, recommendations for efficiencies, and staff performance to ensure efficient functioning of day-to-day business processes.
Duties & Responsibilities
- Oversee Client Managers to ensure organizational goals are appropriately prioritized and defined
- Help define and improve the internal processes of the department
- Define and oversee revenue cycle performance goals and metrics
- Utilize domain knowledge and feedback from internal and external sources to ensure all needs related to Claim and Authorization Denials are met
- Help innovate solutions, effectively target, identify, and manage inventory
- Manage additions and/or reallocation of current staff/processes to ensure client needs are being addressed
- Define client-centric projects and ensure the evolving AR goals of the client and business are met
- Assist with the design and development of projects tailored towards meeting broad industry and local client needs within IT infrastructure
- Implement strategies to improve performance, increase client revenue, and ongoing satisfaction
- Ensure preparedness for client meetings
- Advocate for positive changes to department workflow and staffing which can improve outcomes
- Provide leadership, mentorship, and guidance to department managers and supervisors
- Other duties as assigned
- Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
- Understand and comply with Information Security and HIPAA policies and procedures at all times
- Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties
Qualifications
- Bachelor’s degree in a related field
- 7+ years of experience in hospital revenue cycle roles
- 5+ years of experience as a director, or similar role overseeing staff, within hospital revenue cycle industry
- Clinical experience, such as Physician's Assistant (PA), Nurse Practitioner (NP) or Registered Nurse (RN) required
- Background and familiarity with various Hospital Accounting and EMR Systems
- Solid ability to analyze, interpret and present data in meaningful ways
- Experience managing and overseeing denials programs preferred
- Proficiency in Microsoft Office Suite
- Strong interpersonal skills, ability to communicate well at all levels of the organization
- Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
- High level of integrity and dependability with a strong sense of urgency and results oriented
- Excellent written and verbal communication skills required
- Gracious and welcoming personality for customer service interaction
Working Conditions
- Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes
- Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
- Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
- Work Environment: The noise level in the work environment is usually minimal.
Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.