Revenue Cycle Director Job in Raleigh, North Carolina

• To manage and oversee the Billing Department staff and activities.
• Ensure adherence to and compliance of payer, government, and internal system regulatory policies as they relate to medical billing.
• Monitor aged accounts and verify that appropriate collections procedures are being followed.
• Provide monthly Revenue Cycle Metrics to management along with plans for improvement.
• Resolve escalated reimbursement issues with payers.
• Verify that fee schedules are appropriate against insurance payers and that allowable fees and expected reimbursement calculations are properly stated.
• Maintains oversight of all credentialing processes to ensure ability to bill for services rendered by newly hired providers as quickly as possible.
• Responsible for organizing annual coding audit for providers.  Work with Medical Director to make sure providers receive the appropriate feedback and education on audit results.
• Review and edit all standard policies and procedures for the Billing Department and front-desk staff to insure all policies and procedures are up to date at all times.
• Establish and maintain policies and procedures for front desk duties which involve registration, check-in, payments for services, including co-pays and deductibles as well as cash handling procedures for cash payments and deposits and any other activities that will result in ensuring that PPSAT receives accurate reimbursement for services billed.
• Maintain confidentiality in respect to any and all health center and patient information.

Qualifications

• Bachelor’s degree in related field from accredited college or university; eight to ten years of relevant billing oversight will be considered in lieu of a degree.
• Four to six year’s of billing management experience in a medical office.
• Minimum of one year management/supervisory experience.
• Demonstrated knowledge of all major insurance companies, HMO’s, PPO’s, and Medicaid.
• Experience working in an integrated health care system.
• Must be able to interpret contracts and understand the revenue cycle issues for all payers.
• Master’s degree in related field preferred.
• Five to seven years related experience preferred.
• Demonstrated experience with NextGen preferred.