Advocates

  • Director of Revenue Cycle Management

    Job Locations US-MA-Framingham
    Job ID
    2018-4156
    Type
    Regular Full-Time
    Number of Hours Per Week
    40
  • Overview

    The Director of Revenue Cycle Management is responsible for overseeing the development and implementation of strategies to improve revenue results by taking a global view of clinical and financial processes, functions and interdependencies. This position will work closely with the Billing, Finance and Service Divisions on revenue cycle performance to meet the strategic goals of Advocates. Candidates must be skilled in planning, implementing and managing Revenue Cycle Management (RCM) process and strategies.

     

    Advocates promotes a healthy work-life balance and offers many generous perks of employment and room for advancement.  We are a strong-knit community that values the ideas and contributions of our staff. 

     

    Are you ready to make a difference?

    Responsibilities

    • Develop goals and objectives related to the RCM process, including clearly defined metrics to improve timeliness, accuracy and overall collection rates of claims.
    • Identify, analyze and address challenges and/or breakdowns in the revenue cycle process.
    • Implements a new RCM system and provide oversight and direction on any RCM related technology initiatives; including upgrades, new software, and/or change management.
    • Develop and ensure implementation of policies, guidelines, and procedures as they relate to the RCM process.
    • Monitor effectiveness of activities, ensuring that outstanding authorizations, billings, postings, collections and accounts receivables are within established time limits and that bad debt is within industry standards by conducting routine concurrent and retrospective audits.
    • Enhance and standardize workflows. Develop and implement billing practices by leveraging technology to automate, and standardize processes.
    • Conduct regular meetings with the team to ensure implementation of all RCM plans, programs, and projects are adhering to deadlines.
    • Conduct regular meeting with the Enterprise Applications Team to support in refinement and development of third party billing software system.
    • Conduct regular meetings and communications with Directors overseeing employees generating 3rd party billing to keep them abreast of the targets, trends, changes and necessary requirements to successfully bill.  
    • Responsible for insurance contract review and oversight.
    • Responsible for maximizing the collection of payments and reimbursement from patients, insurance carriers, government agencies, and guarantors.
    • Design/develop training programs for development of technical competencies of the team.
    • Develop performance measures and standards that are used for team's annual performance review.
    • Manage the authorization/billing/collection staff in handling patient/payer relations and handles complex complaints and issues.
    • Delineate, define, and streamline functional activities, ensuring maximum utilization of all resources.
    • Responsible for measuring, monitoring and meeting key performance indicators and departmental goals in accordance with the company's established policies and procedures and industry best practices.
    • Regularly provide CEO, CFO, and revenue cycle staff with revenue cycle status including reports, key performance indicator metrics, and presentations and comprehensive analysis of data as required.
    • Stay abreast of third-party payer billing guidelines and communicate these changes to all interested parties.
    • Ensure all service fee schedules are correctly loaded in the system, billed correctly and reimbursed at the rates agreed.

    Qualifications

    • Relevant Bachelor’s Degree and 6 years’ experience in healthcare billing with 3 years in management; or High School Diploma and 10 years in Healthcare billing with 5 years in management.
    • Extensive knowledge of all aspects of behavioral health billing process.
    • Strong, in-depth knowledge of revenue cycle management principles and practices, including, collections, managed care products, regulatory compliance, payer credentialing, and financial reporting related to behavioral health billing.
    • Meaningful experience in environments with significant numbers of payers and reimbursement methodologies.
    • Experience successfully supporting launching and integrating new products with regards to billing requirements.
    • Strong organizational, leadership and interpersonal skills.
    • Ability to analyze complex process flows and implement changes to improve efficiency and results.
    • Ability to hire, develop, and mentor staff for optimal performance.
    • High energy level, superior interpersonal skills, ability to work effectively independently and in a team atmosphere.
    • Proven ability to delegate, prioritize, and meet strict deadlines.
    • Proven ability to effectively mentor and manage others.
    • Excellent analytical, prioritization, and organizational skills and ability to execute a variety of decision-making models.
    • Excellent written and verbal communication.
    • Strongly prefer a candidate that will have a demonstrated understanding of and competence in serving culturally diverse populations.

     

    Advocates is an EOE/D/F/M/V.

     

    Why Should I Consider a Career in Human Services?

    Our Team members are dedicated to engaging and empowering individuals by forming lasting relationships, collaboratively achieving personal goals, offering creative solutions to everyday and complex situations, and actively listening.  We exercise independent judgement and contribute to the overall success and benefit of the Team.

     

    Is Human Services a Fit for Me?

    Successful Team members are open-minded, eager and compassionate, and will exercise solid, independent judgement while fostering trustworthy relationships with the individuals that we serve.  We put the individual first.

     

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