Head of Revenue Cycle Management

Employment Type: Full-Time
Work Arrangement: Hybrid – Remote work with in-office presence as needed
Locations: Gainesville, Warrenton, Manassas, and Arlington, VA

Summary:

The Head of Revenue Cycle Management is responsible for directing and overseeing all aspects of the organization’s revenue cycle activities. This role focuses on achieving operational goals and cash flow targets by improving revenue cycle processes and ensuring compliance with all regulatory standards.

Duties and Responsibilities:

• Oversee revenue cycle departments including patient billing, utilization management, and financial counseling.
• Manage all components of the revenue cycle including pre-authorization, benefits verification, claims submission, payments, denial management, and appeals.
• Develop and implement strategies to improve revenue cycle processes, reduce denials, and enhance cash flow.
• Monitor revenue cycle performance metrics to ensure KPIs are met or exceeded.
• Implement quality control standards and audits to ensure accuracy and compliance with industry regulations.
• Continuously seek improvements in revenue cycle processes, updating policies, procedures, and training as necessary.
• Develop and maintain relationships with payers and monitor third-party payer compliance.
• Ensure accurate billing information is entered into the billing system and that balancing occurs at the end of day/month.
• Collaborate with clinical and administrative staff to streamline operations and improve the patient experience.
• Ensure compliance with federal, state, and local regulations related to billing and revenue cycle management.
• Utilize necessary software to optimize revenue cycle processes.
• Provide leadership to revenue cycle staff, fostering accountability and continuous improvement.
• Conduct performance evaluations and provide coaching and development opportunities for team members.
• Prepare and present revenue cycle performance reports to the Chief Operating Officer and other executive leaders.
• Stay current with industry trends and best practices in revenue cycle management.
• Perform other duties as assigned by management.

Supervisory Responsibilities:

• Supervise revenue cycle department employees.
• Manage departmental operations including staff interviews, hiring, training, performance reviews, and disciplinary actions.
• Ensure compliance with organizational policies and applicable laws.

Qualifications:

• Bachelor’s degree in Healthcare Administration, Business, Accounting, Finance, or a related field.
• 3+ years of management-level experience in revenue cycle management in a healthcare setting, with expertise in billing and collections.
• Knowledge of patient financial services processes related to billing, collections, and cash posting.
• Proficiency in patient registration, finance, and data processing.
• Strong understanding of TriCare, Medicare, Medicaid, and managed care processes - preferred
• Excellent communication and problem-solving skills.
• Strong analytical abilities with experience in interpreting financial reports and legal documents.
• Experience with relevant software, including Sage Intacct, QuickBooks, Excel, Word, and Outlook.

Competencies:

• Adaptability and ability to manage change.
• Strong analytical and problem-solving skills.
• Business acumen and strategic thinking.
• Excellent customer service and communication skills.
• Leadership and team management skills.

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