Sr. Director, Revenue Cycle
Cascadia
- Portland, OR
- $135,929-149,508 per year
- Permanent
- Full-time
- Lead the Revenue Cycle Department
- Optimize the structure of department's workflow and staffing.
- Responsible for account management, communications with insurance providers, collections, cash posting, contract analysis, and billing.
- Efficiently manage patient complaints in respect of billing and collections.
- Review and approve financial or medical hardship discounts / write-offs.
- Develop policies and procedures across the department
- Ensure Effective Accounts Receivables (A/R) Performance
- Ensure claims are submitted quickly, accurately and in a timely manner.
- Ensure patients understand statements and pay outstanding balances.
- Monitor A/R performance and monitor aging or uncollected balances.
- Audit current procedures to monitor and improve efficiency of billing operations.
- Oversee the coding and denial management processes
- Contract Management
- Oversee the negotiation, creation, and management of contracts within the healthcare industry.
- Ensure compliance with laws and regulations governing healthcare contracts.
- Review and analyze contract terms and conditions.
- Collaborate with internal departments to ensure contract terms meet organizational needs.
- Monitor contract performance and compliance.
- Keep abreast of changes in the healthcare industry that may impact on contracts.
- Credentialing Oversight
- Ensure compliance with regulatory and accreditation standards related to provider credentialing.
- Collaborate with internal departments, such as People and Culture, to ensure provider credentialing requirements are met.
- Manage staff performance
- Provide regular feedback, performance reviews, and one-on-one meetings.
- Oversee the hiring and training of staff.
- Ensure Compliance to Applicable Rules and Regulations
- Routinely monitor billing compliance by reviewing documentation, coding, and billing. This includes working with Information Technology (IT) and the providers to improve accurate charge capture when CID-10-CM and CPT/HCPCS codes are updated.
- Work with the organization's HIPAA Privacy/Security Officer to ensure new hire and annual training is conducted with your entire department workforce.
- Perform other job-related duties as assigned
- Sound knowledge of health insurance programs and contracts
- Possess in-depth knowledge and understanding of Medicare, Medicaid, and Managed Care regulations.
- Proficiency in Excel including but not limited to Pivot Tables and Lookup functions
- Ability to adapt to changing technology
- Ability to read, interpret, research, explain and apply laws, rules, regulations, policies, and procedures related to program business
- Ability to prepare complex reports