Chief Revenue Cycle Officer

Summary: This position is responsible for the organizations revenue cycle process, exceeding industry and HealthPoint KPIs and organizational targets and maximizing revenue and patient and insurance collections in compliance with payer regulations.

Starting Salary: $130k

- Directs daily operating functions of revenue cycle process, Revenue Cycle Managers and non-exempt staff and develops and enforces policies, procedures and training materials to meet department goals.

- Proactively manages patient collections and the sliding fee scale verification process, develops tools and supports operations to effectively train registrars in all offices to meet >95% time of visit collection rate to accurately verify insurance eligibility and copay/coinsurance to collect at visit.

- Manages EDI and the Practice Management System to accurately bill claims and post payments.

- Manages payer contracts and fee schedules.

- Ensures staffing and plan to meet organizational billing goals, denial correction and turnaround in <48 hours, ongoing review of claims by days aging per policy and KPIs monthly and validates accuracy and completeness prior to EOM close.

- Ensures patient and insurance credits are worked timely and resolved per policy.

- Continuous analysis of AR, metrics and denial trends and reimbursement patterns and develops workplans or projects to maximize reimbursement.

- Communicates effective strategies for improving revenue cycle process to CEO, COO, CFO, Practice Administrators and staff on a regular basis, completes weekly or as needed trend analysis, and formulates an action plan to remedy any deficiencies or issues identified timely.

- Communicates with payers and third parties and submits required claims data to resolve outstanding claims issues timely.

- Meets deadlines for month end close and accurately generates and analyzes monthly reporting (month end close by 5pm on the first business day of each month and reporting complete by noon of the third business day of each month)

- Proactively studies, recommends and leads implementation of revenue cycle improvements

- Manages and sets standards for compliance with Federal, State and payer rules and regulations and reporting, including, but not limited to UDS reporting and quarterly Medicare Credit Balance reports, Medicare wrap applications, escheatment account review and Medicare bad debt review.

- Ensures providers are credentialing timely and coordinates with COO/Credentialing Specialist to assist as needed with facility, provider and payer credentialing process as assigned

- Ensures completion of prospective coding audits in accordance with the Organizations Corporate Compliance Policy

- Manages Medicaid and Medicare wrap claims to ensure timely payment and initiates HealthPoint COO/CEO involvement for missing payments

- Stays knowledgeable about FQHC billing and operations

- Proactively ensures superior customer service to internal and external customers including phone/portal patient communication according to standards set by HealthPoint Family Care

- Develops and leads ongoing revenue cycle training, coding education and registration training for all providers and staff

- Keeps staff informed of changes in department, centers, policies, or procedures through daily communication and monthly staff meetings.

- Retains high performing staff through timely feedback, coaching, supervision and evaluations

- Addresses employee performance problems through effective and timely corrective actions.

- Follows established regulations and professional standards as required of the position. Participates in and supports continuous quality improvement and innovative use of technology and billing software, including proactively researching automation of revenue cycle tasks

- Other duties and responsibilities as assigned by the COO.

Qualifications

- Bachelor's degree (B. A.) from four-year college or university; or five years related experience and/or training; or equivalent combination of education and experience.

- Prior experience demonstrates the ability to comprehend and solve practical problems with a variety of concrete variables.

- Demonstrated experience with software programs to include Microsoft excel, Microsoft Word, Microsoft Outlook, and Internet and Intranet research.