Director – RCM Operations
As the Director of RCM Operations, you will be responsible for overseeing and enhancing the revenue cycle management processes within our healthcare organization. You will play a pivotal role in ensuring efficient billing, coding, and collection operations while maximizing revenue and minimizing financial risks.
- Develop and implement a strategic vision for the revenue cycle management department.
- Lead, mentor, and manage a team of RCM professionals to ensure efficient and effective operations.
- Collaborate with senior leadership to align RCM strategies with the organization’s financial goals.
- Ensure accurate and timely medical coding, billing, and claims submission.
- Oversee the monitoring and resolution of coding and billing errors to prevent claim denials.
- Implement and maintain compliance with coding and billing regulations, such as ICD-10 and CPT codes.
- Analyze revenue cycle data and key performance indicators (KPIs) to identify trends and areas for improvement.
- Develop and maintain financial reports to monitor revenue, accounts receivable, and cash flow.
- Identify and implement process improvements to streamline revenue cycle operations.
- Optimize revenue collection by reducing days in accounts receivable and improving denial management.
- Stay up-to-date with healthcare regulations and insurance policies to ensure compliance.
- Develop and maintain policies and procedures that adhere to industry standards and guidelines.
- Evaluate and select RCM software and tools to enhance operational efficiency.
- Implement and maintain electronic health records (EHR) and practice management systems.
- Ensure a positive patient financial experience by providing support and resolving billing-related inquiries.
- Manage relationships with RCM service providers and payers.
- Negotiate contracts and agreements to optimize reimbursement rates.
- Bachelor’s degree in healthcare management, business, or a related field (Master’s degree preferred).
- Minimum of 15 years of experience in revenue cycle management or related roles.
- Strong knowledge of healthcare billing, coding, and compliance.
- Excellent leadership and team management skills.
- Proficiency in using RCM software and electronic health records systems.
- Understanding of healthcare regulations, such as HIPAA and Medicare/Medicaid.
- Strong analytical and problem-solving skills.
- Effective communication and negotiation abilities.