Revenue Cycle Director

Affinity Executive Search in Lincoln, NE

  • Industry: Accounting - Corporate Accounting - Senior
  • Type: Full Time
  • Compensation: $91,905.00 - 194,850.00 / Year*
position filled


POSITION SUMMARY: This position isresponsible for strategic alignment, management, and daily oversight ofthe organizations revenue cycle functions including patient access, patient billing (including claims production), health information management (including coding), insurance follow-up, self-pay collections, cash receipts /adjustments (including administrative, bad debts, and charity care), compliance with third party payer regulations, insurance verification and provider enrollment/credentialing.The success of this position will be measured by improvement in key revenue cycle indicators such as: A/R days - gross, cash collections, bad debt expense percentage and provision for charity care percentage, denial percentage, and percentage of accounts over ninety (90) days old.

This individual should have comprehensive knowledge of revenue cycle operations, either from a provider or payer perspective, with particular experience in performance improvement identification/implementation and monitoring controls.This position is responsible for personnel development, implementing and maintaining department policies and procedures, and initiating disciplinary action according to policy.This position ensures that the highest standards for the protection of confidential information which includes the security and integrity of the electronic health records. This position also serves as the Chief Privacy Officer who oversees all activities including the development, implementation, and maintenance of all policy and procedures to assure compliance with the Health Insurance Portability and Accountability Act of 1996.

SUPERVISION:Reports to Chief Financial OfficerSHIFT:Full-Time, Exempt


Bachelors degree required, preferably in Business or Healthcare Administration (extensive experience and a successful track record in Revenue Cycle Management would be considered in place of a Bachelors degree)

Masters Degree in a related field preferred (MBA, MHA)


Relevant industry license/certifications preferred (CRCE, CRCP, CPAM, CRCR, CHFP or RHIT)

Participation in relevant industry professional associations preferred (AAHAM or HFMA)

Experience with Critical Access Hospitals and Rural Health Clinics required

Successful history working with Medicare/Medicaid payment plans and regulations

Intermediate computer skills in Microsoft Office, with preferred experience in CernerEHR system

Knowledge of CPT, HCSPCS, ICD-10 coding, revenue codes, & hospital/physician billing (claims processing)

Demonstrates highly developed verbal and written communication skills, excellent analytical and problem solving skills, the ability to assess and evaluate complex financial data, and the ability to manage multiple complex tasks

Exhibits excellent leadership and self-direction, good judgment in handling difficult situations and good organizational, time management, interpersonal and conflict resolution skills


Ensures accounts are billed accurately and timely by providing proactive oversight and direction for patient registration, billing, and collections, including but not limited to: inpatient, outpatient, emergency room, clinic, lab, rehab, and surgery.(collections are currently outsourced)

Provides operational oversight for Patient Access Supervisor and HIM/Billing Supervisor, mentoring them in their responsibilities

Maintains current knowledge of hospital billing systems and government payment systems, including applicable federal/state laws and regulations, as well as all aspects of third party reimbursement policies and practices

Develops and implements HIM and Patient Access/Patient Accounting policies and procedures in accordance with applicable laws, regulations, and sound business practices

Demonstrates ability to supervise, train and motivate employees, as well as a professional attitude in relating to executive management, professionals, third-party insurance carriers, and business/community leaders

Organizes and leads intra-departmental efforts to maximize operational efficiency and optimize reimbursement, as well as monitors denials and provides education and reporting to clinical areas regarding the effect of denials from their area

Selects and monitors outside collection and early out vendors engaged in the collection of accounts receivable, reviews and balances agency reports to hospital system reports, and approves agency invoices

Assures that confidentiality of patient information is maintained without exception and satisfactorily handles customer complaints within organization guidelines

Attends all required meetings and activities, maintaining a professional affiliation to stay abreast of current trends and changes in legislation and industry best practices

Develops and implements Privacy Policies in compliance with the Health Insurance Portability and Accountability Act.

Develops and implements departmental budget(s).

Develops departmental objectives and goals in addition to organizing the work load with staff.

Interviews/hires all staff in addition to performing performance evaluations and recommended wage increases, promotions, or disciplinary actions.

Prepares statistical analysis and reports to mandatory agencies.

Actively participates in revenue cycle improvement activities, including leading the Revenue Cycle Steering Committee.

Oversees the audits of electronic health records to assure compliance with access in accordance with the privacy regulations and performs initial and periodic information privacy risk assessments.

Manages and oversees transcription services.

Oversees or ensures delivery of initial privacy training and orientation to all employees, volunteers, and contracted employees.

Selects and monitors outside coding vendor, ensuring compliance and quality standards are met, and approves agency invoices.

Oversees the accurate assignment of diagnosis and procedure codes to all hospital and clinic visits for both in house and third party coders.

Performs all performance improvement activities for the department(s).

Ensures that quarterly audits of accounts for coding performance are performed.

Performs trend analysis on third party payer payment levels to ensure that reimbursement is in accordance with allowable amounts stated in agreements and contracts. Works with payer representatives to resolve discrepancies.

Performs trend analysis of third party payer rejects and denials. Develops training programs for registration, billing and coding staff to eliminate/reduce rejects/denials

Provides analysis and education to physicians through monthly attendance to provider meetings.

Performs other duties as assigned.

* Estimated salary

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