Director of Revenue Cycle, Chicago, IL
The Director of Revenue Cycle is responsible for maximizing the collection of medical/behavioral health/dental services payments and reimbursements from patients, insurance carriers, financial assistance, and guarantors, insurance eligibility processes, charge processing, claim submission and processing, payment processing, collections and accounts receivable management, denial management, reporting of results and analysis, concurrent and retrospective auditing, proper coding, credentialing, insurance contract review and oversight, customer services relative to revenue cycle, training and development relative to revenue cycle, analytics, and all other revenue cycle management activities.
DESCRIPTION OF DUTIES:
- Hire, train, supervise, and evaluate all staff in the Billing Department.
- Develop and maintain procedure for efficient and accurate processing of encounters in the registration area.
- Supervise, monitor, and reconcile third party insurers billing, reimbursement, cash collections and receivables.
- Develop new, or modify, patient billing procedures.
- Institute and provide oversight of patient payment plans.
- Monitor delinquent accounts and work with patients to collect outstanding balances.
- Oversight of all business related functions of the patient visit from point of entry to accurate adjudication of the patients’ accounts.
- Develop and implement revenue cycle training, in regards to related responsibilities with registration, claims management, billing/coding, collections, patient insurance, data processing, integrity of patient accounts, accounts receivable management, practice management system file maintenance, and third-party revenue cycle vendors.
- Provide necessary billing/coding training to providers.
- Analyze and report on records and registration information analyzing claims, utilization, and medical cost data.
- Monitor aged accounts and verify appropriate collection procedures are being followed.
- Develop, analyze, and share reporting and metrics regarding the revenue cycle status.
- Establish internal goals and identify external benchmarks, including guiding individuals and teams toward priorities, clarifying roles and responsibilities, coordinating resources, and arranging organizational systems to meet objectives.
- Enroll and credential all providers (physicians, physician assistants, nurse practitioners, mental health providers, dentists,etc.) and clinics with all insurance companies, including Medicaid and Medicare.
- Assist in preparing UDS reports, and prepare monthly statistics for reporting to the CFO.
- Update PrimeCare’s fee schedule, as needed, but annually at a minimum.
- Other duties, as assigned.
- Bachelors’ degree in Finance, Accounting, Business Administration, or equivalent OR 8 years of progressive revenue cycle management experience required
- At least two years supervisory experience, preferably supervising hourly staff.
- Demonstrated knowledge of health center billing operations.
- Strong knowledge of medical, behavioral health, and dental insurance billing and collections with CPT, ICD-10 and HCPC coding and medical terminology.
- Proficiency in Microsoft Office (Outlook, Excel, Word, and PowerPoint primarily).
- Prior Athena (EHR) experience preferred.
Benefits include PTO, Health/Dental/Vision Insurance, Short-term and Long-term Disability Coverage, Life/AD&D, 403(b), paid holidays.
Please send cover letter and resume to:
Javier Alaniz, Human Resources Generalist
PrimeCare Community Health, Inc.