Director, Revenue Cycle Management

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee all revenue cycle operations for MSO clients, which encompasses charge capture, coding, claim submission, payment posting, denials management, and accounts receivable follow-up.

• Create and track KPIs such as days in A/R, clean claim rate, denial rate, net collection rate, and first-pass resolution; provide results to leadership and clients.

• Detect revenue leakage and implement process enhancements to boost collections and minimize write-offs.

• Generate and present monthly financial reports that include charges, collections, adjustments, denials, A/R aging, and payor mix.

• Report on financial outcomes for practices, focusing on revenue trends, provider productivity, and performance relative to budgets and benchmarks.

• Analyze variances and opportunities, presenting insights and recommendations to clients and Oasis Health leadership.

• Ensure accurate, timely, and consistent reporting across all clients.

• Lead, mentor, and develop a large distributed team of coders and billing personnel.

• Oversee auditing, education, and feedback processes to ensure coding quality complies with CPT, ICD-10-CM, HCPCS, and payor-specific guidelines.

• Establish productivity and accuracy benchmarks, manage workloads, and develop training programs.

• Review and interpret payor contracts and fee schedules; identify underpayments and opportunities for reimbursement.

• Assist or oversee provider enrollment and credentialing procedures.

• Act as an escalation point for payor disputes, appeals, and reimbursement challenges.

• Serve as the senior point of contact for client practices through video and phone meetings; discuss results, recommendations, and address concerns.

• Facilitate client onboarding and transitions, including workflow design and system setup.

• Utilize EMR and practice management systems, especially athenahealth and eClinicalWorks, to enhance workflows, reporting, and billing configuration.

• Manage simultaneous client implementations, system conversions, and process improvement projects from planning to execution.

• Ensure compliance with HIPAA, CMS, and payer regulations, including the secure handling of PHI in a remote setting, and support internal and external audits.

⛳️ Requirements

• Over 10 years of progressive experience in medical coding and billing, with comprehensive hands-on expertise in the complete revenue cycle.

• In-depth knowledge of payor contracts, reimbursement methodologies, and denial and appeals processes.

• Familiarity with provider credentialing and payer enrollment procedures.

• Experience with EMR and practice management systems.

• Proficient in preparing and presenting practice financial reports and analyzing financial performance.

• Proven leadership experience managing large coding or billing teams, preferably in a remote environment.

• Strong project management abilities with the capability to prioritize tasks in a fast-paced setting.

• Exceptional written and verbal communication skills.

• High degree of professionalism and capability to engage directly with clients and executives.

• Self-driven, with a secure home office and dependable high-speed internet connection.

• Prior experience in an MSO, billing organization, or multi-practice environment is preferred.

• Familiarity with athenahealth and eClinicalWorks (eCW) is advantageous.

• CPC, CCS, CRCR, or similar certification is preferred.

• Experience in value-based care or multi-specialty practices is a plus.

• Bachelor's degree in healthcare administration, finance, business, or a related field is preferred.

• Must be authorized to work in the United States without the need for current or future visa sponsorship.

• Must currently reside in the United States.

🏝️ Benefits

• Medical insurance.

• Dental insurance.

• Vision insurance.

• 401(k).

• Generous time off plans.

• Professional development program starting with onboarding and continuing throughout your career.

• Remote work environment.

• A secure home workspace and reliable high-speed internet are required for remote work.