Revenue Cycle Director Job in Sumter, South Carolina

Position Summary: 

The Revenue Cycle Director (RCD) directs and oversees all revenue cycle-related activities for the organization in order to optimize the organization’s profitability and patient care continuum. The RCD will assist with setting Tandem Health financial policies and direction related to the revenue cycle, while also being an active participant in helping drive the organization’s overall financial strategy, business planning, and budgeting. This position will work closely with Chief Financial Officer to analyze billing and financial data in comparison to the operational budget.

Duties and Responsibilities: 

•         Works closely with Athena staff to monitor outstanding accounts receivable to ensure timely payments and claims resolution to maximize revenue. 
•         Works closely with provider relations staff at insurance companies to resolve outstanding billing issues.
•         Oversees the work of the Revenue Cycle Manager and overall supervision of the Billing department.
•         Ensures adequate staffing levels for the Billing department, which may include emergency coverage by the Revenue Cycle Manager and Director during unexpected absences.
•         Works closely with Compliance department to ensure compliance with all billing and collections practices. 
•         Reviews insurance contracts for accuracy and revenue maximization. 
•         Oversees and assists, as needed, with reviews and updates to the fee schedules on an annual basis. 
•         Assists CFO with audit activities.
•         Assists Tandem Health leadership in the annual budgeting and planning process.
•         Supports the CFO in engaging the Board of Directors’ Finance Committee around issues and trends in the revenue cycle.
•         Assists CFO with management of cash flow and forecasting.
•         Oversees A/R collections
•         Assists with monthly A/R reconciliation for medical and dental service lines.
•         Provides reporting input for UDS, SAC grant as well as the Medicare and Medicaid cost reports.
•         Ensures that all appropriate laws and regulations governing billing and collections are followed.
•        Remains up-to-date on all billing guidelines, specifically those affecting the business of Federally Qualified Health Centers (FQHC) 
•         Keeps CFO informed of regulatory changes affecting the revenue cycle.
•         Demonstrates cooperative co-worker and community relationships by remaining friendly, polite, helpful, open-minded, and non-critical/judgmental of others;  
•         Promotes a calm and effective work environment by maintaining appropriate emotional control and displaying appropriate behavior at all times. 
•         Builds a team, resolves conflict, and facilitates group interaction both within the team and with cross-departmental teams. 
•         Facilitates assigned staff time and attendance to include requests for Paid Time Off and minimizing overtime. 
•         Oversees the hiring, orientation and training and development of assigned team members. 
•         Provides coaching and counseling utilizing Center-approved performance feedback tools and methods. 
•         Maintains a strong focus on ensuring that all work efforts are aligned with organizational goals and objectives. 
•         Enables staff to achieve optimal results by providing information, encouragement and support.
•         Performs other duties as assigned

Qualifications: 

Education and Experience:

•         Bachelor’s degree in relevant field required.
•         A minimum of five (5) years Billing and Collections experience required. 
•         A minimum of three (3) years of supervisory experience required.
•         Certified Professional Coder (CPC) required.

Knowledge, Skills, and Abilities:

•         Must possess considerable knowledge of the principles and practices of accounts receivable, billing and collections practices, including, but not limited to, third party, Medicare and Medicaid payors, as applicable in the FQHC setting.
•         Ability to adjust to the changing needs of the health center.
•         Ability to work independently and collaboratively to achieve goals.
•         Ability to effectively lead and engage a team to accomplish goals.
•         Must be able and willing to work as a team member and a leader.
•         Highly organized and detailed.
•         Exercise sound judgement and decision-making; able to assess and differentiate priorities.
•         Excellent interpersonal skills.
•         Excellent written and verbal communication skills.
•         Able to maintain confidentiality in all aspects of information (including patient data) in accordance with center’s philosophy and policy, and state and federal regulations. Must handle the most sensitive and confidential matters with the utmost discretion.
•         Proficiency with computer skills (i.e. Microsoft Word, Excel, Access, and web-based applications).
•         Able to learn new software programs. 

Work Environment: 

Very busy atmosphere.  Highly stressful when dealing with individual personalities of co-workers, patients and their families.  Potential for rare exposure to blood-borne diseases (Category II).  Potential for rare exposure to chemical hazards (Category B).

Physical Demands: 

Considerable sitting, standing or walking. Lifts supplies/equipment up to 20lbs occasionally, and/or up to 10lbs frequently.  

Please visit our website at www.tandemhealthsc.org to complete an online application.