Director of Revenue Cycle Management - Advocates - Framingham, MA

Overview

The Director of Revenue Cycle Management provides operational oversight, leadership and subject matter expertise in the completion of all Revenue Cycle activities for the agency. This position will evaluate, develop, implement and monitor policies and procedures designed to maximize amounts billed and collected for services delivered. 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 measure timeliness, accuracy and overall collection rates of claims.
  • Identify, analyze and address challenges and/or breakdowns in the revenue cycle 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.
  • 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 within deadlines.
  • Conduct regular meetings and communications with Directors overseeing employees generating 3rd party claims to keep them abreast of the targets, trends, changes and requirements necessary 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.
  • Manage the authorization/billing/collection staff in handling patient/payer relations and handle complex complaints and issues.
  • 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.
  • Hire, train and supervise staff responsible for daily revenue cycle activities.

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.
  • 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.
  • Excellent analytical, prioritization, and organizational skills
  • Excellent written and verbal communication skills.
  • 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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