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BrightSpring Health Services · 2 months ago

Senior Director Of Revenue Cycle

Nashville, TN

Full-time

Onsite

Director/Executive

10+ years exp

BrightSpring Health Services is a provider of home- and community-based pharmacy and health solutions. The Sr. Director of Revenue Cycle is responsible for managing the Revenue Cycle organization to ensure timely billing, maximize collections, and resolve billing-related issues while leading strategic initiatives and improving efficiency.

Health CarePersonal HealthPharmaceutical

Responsibilities

Manage all aspects of the revenue cycle including but not limited to billing, collections, cash posting, contract analysis, communications with insurance providers, and account management. Perform all end of month closing procedures

Develop sustainable processes to bill and adjudicate claims timely to maintain a benchmark cash goal

Develop denial management processes to eliminate denial root causes and reduce the denial impact on the organization. Collaborate with clinical departments to resolve and expedite solutions

Partner with contracting and operations teams to evaluate collection capabilities and adherence to payer contracts

Ensure maximization of cash collections through diligent and timely monitoring of all open accounts receivable balances

Establish key metrics and performance indicators aligned with Provider Revenue goals; analyze operating results and take adequate steps to correct shortfalls in quality and collections performance

Manage individual(s) including, but not limited to, hiring, training, work assignments, manage and evaluate performance, and conduct professional development plans. Ensure that the productivity and actions of the managed group meet and support the quality goals

Determine teams training requirements and ensure that timely and effective training is performed to enhance the skill base of the team

Adhere to all policies and procedures, within the most stringent attention to complying with all governmental and HIPAA mandated patient protections

Account for internal control responsibilities in line with the organization’s objectives

Investigate and resolve complex RCM problems and coordinate efforts to provide innovative strategies and solutions

Stay abreast of payer requirements and changes in the industry and communicate those changes to team and leadership

Assess and respond to current and future internal and external healthcare trends to establish and ensure the necessary direction for revenue cycle activities

Qualification

Revenue Cycle ManagementProfessional BillingHealthcare RegulationsTeam LeadershipFinancial Performance OptimizationWorkflow DesignMedical TerminologyMicrosoft Office SuiteAnalytical SkillsChange ManagementCommunication SkillsOrganizational SkillsTime Management

Required

Requires a bachelor's degree of accounting, finance or Business Management or related field of study

10+ years of progressive management experience

At least 8 years of experience managing Professional Billing / Revenue Cycle Management and/or Collections in a large healthcare provider setting or a Medical Claims Processing organization

Proven experience in successfully leading revenue cycle teams (larger than 20 employees) and implementing strategic initiatives to optimize financial performance and maximize cash collection

Experience in designing and executing workflows to operationalize best practice strategies for payments/collections

Extensive knowledge of government and payer billing regulations and payer requirements

Understanding of third-party payer contracting language and reimbursement terms

Experiences with multiple billing and eMR systems

Solid grasp of medical terminology, ICD9/10, CPT, and HCPC coding

Strong organizational, time management, and analytical skills

Possesses the versatility required to be a leader, manager, teacher, coach, and mentor while placing high value on people and process

Demonstrated proficiency in Microsoft Office Suite (Power Point, Word and Excel) at the intermediate to advanced level

Excellent communication and interpersonal skills to collaborate with internal stakeholders, including CFO, finance teams, and senior executives, as well as external partners such as payers and vendors

Ability to drive change, manage multiple complex projects, and deliver measurable results

Must be able to assess situations, identify issues/problems and prioritize duties

High ability to thrive in a fast-paced, highly dynamic environment and leverage available data to be decisive in unstructured environments

Travel 25-50% to regional Business Centers and Support Center