Director of RCM Operations

Job Description

Rethink Behavioral Health is the leading global provider of online research-based resources to support individuals with developmental disabilities. Our behavioral health platform (http://RethinkBH.com) provides clinical, staff training, and practice management tools for private ABA service providers. Due to autism insurance mandates sweeping the nation, our behavioral health division is experiencing unprecedented growth. Therefore, we are looking for the right person to join our billing service team.

Our office specializes in Revenue Recycle Management, as well as Enrollment and Credentialing Services, for behavioral health providers. We are looking for an experienced professional who will promote a positive work environment through progressive leadership. We support mission-oriented companies that impact the lives of thousands of individuals with autism and their families. We are excited to offer the opportunity for professional and collaborative individuals to be a part of a growth-oriented business.

The Director of RCM Operations will play a key role in the continued development and growth of the RCM function, working closely with the VP of Revenue Cycle Management as well as other leaders within the RCM team. You will have responsibility in driving operational excellence across our Billing, Collections, and RCM QA function , keeping our customers at the heart of every decision being made. You will have oversight and partner closely with leadership in our Center of Excellence in Pune, India , with a focus on driving innovation and process automation across every aspect of our billing and collections process.

Location: Remote opportunities are available to candidates who reside in the following states: AL, AZ, AR, CA, CO, FL, GA, ID, IL, IN, IO, MO, NE, NY, NC, OH, PA, SC, TN, TX, UT, VA

Main Responsibilities:

• Ensure strict HIPAA-compliant confidentiality with all client-related data

• Build and oversee A/R team to manage assigned accounts and mitigate AR backlog

• Oversee QA manager & work closely with QA team to improve program and processes developed for RCM team across functions

• Assist in developing strategic plans/programs to enhance RCM functionality to exceed the goals/objectives assigned to the RCM team.

• Delineate, define, and streamline functional activities, ensuring maximum utilization of all resources in the US and India.

• Travel to India to meet with the team at least twice a year.

• Assist in identifying, analyzing, and addressing challenges and/or breakdowns in the processes across the RCM Team

• Oversee Vendor productivity and performance, including management of procedures and workflows

• Make recommendations to Rethink leadership to address and improve our customer’s experience.

• Aid in account escalations from management and clients to ensure a timely resolution is reached & communicated when needed

• Assist in monitoring/updating project plans surrounding key initiatives for the RCM team and assure deadlines/goals are being met

• Assist in monitoring/updating internal and external reporting requirements.

• Regularly provide VP of Revenue Cycle Management with status updates including account escalations, weekly KPI reporting, staffing concerns and quality assessments

• Assist in the development and execution of growth strategy initiatives (e.g. Integrated Billing system roll-out, acquisition integration) to achieve RCM revenue targets

• Evaluate Vendor performance, provide feedback and deliver/monitor action plans

• Identify and implement process improvements and workflow automation of RCM functions

• Interview candidates, as needed

• Other special projects/assignments as needed

Required Qualifications 

• Minimum 7 years of experience with demonstrated expertise in successfully managing a high-performance RCM operation while meeting or exceeding industry benchmarks

• Minimum 7-10-years Insurance Billing experience which includes knowledge of ICD-10 and CPT guidelines

• Experience managing or closely working with offshore teams/vendors. Experience working with a team in India is strongly preferred.

• ABA (Applied Behavior Analysis) billing experience

• Strong knowledge of billing software, preferably Tebra, Azalea and Central Reach

• Strong, in-depth knowledge of revenue cycle management principles and practices; including medical billing, coding, collections, managed care products, regulatory compliance, payor credentialing, and financial reporting

• Exceptional written and oral communication skills

• Exceptional attention to detail and accuracy

• Positive & Development-oriented

• Must be a “Hands-on” Leader working with clients and internal teams.

• Strong leadership qualities

Preferred Qualifications and Experience

• Bachelor’s degree preferred

• Minimum of 5 years Supervisory experience

• Experience leading teams

• Customer service experience required

• Proficient using Microsoft Suite (Excel, Outlook, Word)

• Experience using billing software Kareo or Azalea

Benefits:

• Three weeks of paid time off, in addition to 7 paid holidays

• Generous Health, Dental & Vision benefits package

• 401k eligible after a year of employment