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Director of Revenue Cycle Management

Position Overview: The Director of Revenue Management reports to the CFO andis responsible for overseeing the development and implementation of current andfuture strategies to improve revenue results by taking a global view ofclinical and financial processes, functions and interdependencies. Thisposition will work closely with the Billing, Finance and Clinical Departmentson revenue cycle performance to meet the strategic goals of FranciscanChildren's. Candidates must be experts in planning, implementing and managingRevenue Cycle Management (RCM) process and strategies. The Director will be responsible for RCM technologystrategy and initiatives, insurance eligibility processes, charge processing,claims submission, payment posting, collections and accounts receivable, denialmanagement, reporting results and analysis, concurrent and retrospectiveauditing, proper coding, insurance contract review and oversight, customerservices relative to revenue cycle, training and development related to revenuecycle, analytics of key performance indicators, and all other revenue cyclemanagement activities. This work is carried out in support of the missionand goals of Franciscan Children's. Essential Functions: ? Develop strategicplans/programs for RCM team and ensure goals/objectives are properly definedand clearly established. ? Identify, analyze andaddress challenges and/or breakdowns in the revenue cycle process. ? Implementsa new RCM system and provide oversight and direction on any RCM relatedtechnology initiatives; including upgrades, new software, and/or changemanagement. ? Develop and ensureimplementation of policies, guidelines, and implementation procedures. ? Monitor effectiveness ofactivities, ensuring that outstanding authorizations, billings, postings,collections and accounts receivables are within established time limits andthat bad debt is within industry standards by conducting routine audits. ? Enhance and standardizeworkflows. Develop and implement billing practices by leveraging technology toautomate, and standardize processes. ? Conduct regular meetingswith the team to ensure implementation of all RCM plans, programs, and projectsis adhering to deadlines. ? Responsible for maximizingthe collection of payments and reimbursement from patients, insurance carriers,government agencies, and guarantors. ? Design/develop trainingprograms for development of technical competencies of the team. ? Develop performancemeasures and standards that are used for team's annual performance review. ? Manage theauthorization/billing/collection staff in handling patient/payer relations andhandles complex complaints and issues. ? Design and develop the organizationstructure for RCM team. ? Delineate, define, andstreamline functional activities, ensuring maximum utilization of allresources. ? Responsible for measuring,monitoring and meeting key performance indicators and departmental goals inaccordance with the company's established policies and procedures and industrybest practices. ? Regularly provide CEO, CFO,and revenue cycle staff with revenue cycle status including reports, keyperformance indicator metrics, and presentations. ? Stay abreast ofMedicare/Medicaid and third-party payer billing guidelines and communicatethese changes to all interested parties. ? Other specialprojects/assignments as needed. Minimum Experience and Skills Required: ? Five (5) years of experience with demonstrated expertisein successfully leading and managing a high-performance revenue cycle operationwhile meeting or exceeding industry benchmarks. ? Strong, in-depth knowledge of revenue cycle managementprinciples and practices, including medical billing, coding, collections,managed care products, regulatory compliance, payer credentialing, andfinancial reporting. ? Solid financial management skills, including budgeting,forecasting, trending, benchmarking, and financial analysis of the departmentperformance. ? Strong skills in Microsoft Office products. ? Strong knowledge of EHR software, preferably MEDITECH. ? Experience with patient billing management software. ? Exceptional attention to detail and accuracy. ? Knowledge of ICD and CPT guidelines. ? Excellent written and oral communication skills. Education, Licenses and/or Certifications Required: ? Bachelor's Degree in related field.



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