R1 RCM · 1 day ago

Director Revenue Cycle Operations - Payer Accountability

Remote, USA

Full-time

Remote

Director/Executive

$106K/yr - $158K/yr

8+ years exp

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Health CareHospital

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Responsibilities

Develop and implement strategies to improve payer escalation processes.

Lead and mentor a team of RCM professionals focused on payer escalation.

Collaborate with senior leadership to align payer escalation strategies with organizational goals.

Establish and sustain strong relationships with key payers.

Negotiate resolutions for escalated issues to ensure effective problem-solving and client satisfaction.

Monitor and analyze payer performance, identifying trends impacting revenue

Utilize data analytics to identify patterns and root causes of payer-related issues.

Prepare and present reports on payer performance and escalation outcomes to senior leadership.

Develop and monitor key performance indicators (KPIs) related to payer escalation.

Leads a high-functioning team of AR resolution experts & drives leadership accountability to meet and exceed performance targets.

Develops team members to proactively identify and understand revenue cycle issues in conjunction with payor contracts and adjudication practices.

Conducts a strong team culture of collaboration, being in service to our clients, internal departments, and each other to drive results.

Collaborate with the R1 Product team to enhance workflow automation and identify problematic accounts through customized analytics, regulatory compliance, and contractual terms.

Work closely with internal teams, such as billing, coding, and compliance to address and resolve payer-related issues.

Partner continuously with Managed Care Analytics to develop innovative and customized analytics based on payer adjudication trends and evolving regulatory requirements.

Analyze and optimize existing payer escalation processes.

Implement best practices and innovative solutions to enhance efficiency and effectiveness.

Ensure compliance with industry regulations and standards throughout the escalation process.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Revenue Cycle ManagementPayer RelationsData AnalyticsLeadership ExperienceData Reporting ToolsHealthcare Regulations KnowledgeProcess OptimizationCross-Functional Collaboration