Director, Revenue Cycle Management

WHAT YOU’LL DO

• Responsible for overseeing and managing the financial operations related to the revenue cycle which include the following:
• Develop and implement strategies to optimize revenue cycle and maximize revenue generation
• Manage and lead revenue cycle team including Billing and coding manager, Patient billing manager
• Ensuring compliance with all regulations and guidelines such as HIPAA and CMS billing requirements
• Negotiate and maintain relationships with Commercial Payors to facilitate timely and accurate reimbursement
• Monitor and Analyze KPIs related to revenue cycle performance such as days in AR, denial rates and cash collections
• Manage EHR/Medical billing Partner, holding them accountable to contract obligations, and SLAs
• Identifying and implementing process improvements to enhance efficiency and effectiveness in revenue cycle operations
• Providing training and education to staff on revenue cycle processes, policies and procedures
• Conducting regular audits to ensure accuracy of billing practices and no revenue leakage
• Oversee Weekly billing processes, including reporting and account balancing

WHAT YOU’LL BRING

• Must have excellent organizational skills, communication skills, and the desire and ability to learn and move quickly
• Knowledge and experience working with big commercial payers
• Knowledge of professional fee billing, reimbursement, third-party payer regulation, and medical terminology is required
• Working knowledge of regulatory requirements pertaining to health care operations and their impact on operations
• Strong problem-solving skills and ability to make timely decisions
• Strong attention to detail
• Demonstrated coding and billing knowledge/experience preferred
• Experience with the provider payor credentialing process

WHAT WILL GIVE YOU AN EDGE

• Proven track record with other startups or VC funded companies
• Bachelor’s Degree in Business, Healthcare Administration or equivalent and a minimum of five (5) years of medical billing experience
• The ability to coordinate and negotiate rates and contracts on behalf of Circle Medical with commercial payers
• Command of revenue cycle management principles, including working knowledge of cash posting processes, medical record guidelines, coding, and accounts receivable follow-up (e.g. HCPCS, CPT, ICD codes)
• Manager/supervisory experience is a big plus