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Integrative Emergency Services · 1 day ago

Director of Revenue Cycle - Specialty Services

Dallas, TX

Full-time

Hybrid

Director/Executive

10+ years exp

Integrative Emergency Services, LLC is seeking a Director of Revenue Cycle - Specialty Services who will oversee the billing and revenue cycle functions for physician practices in specialty service lines. The role involves strategic oversight, operational management, and collaboration with service line leadership to optimize reimbursement and ensure compliance.

Emergency MedicineHealth CareHospital

Hiring Manager

Jonathan Sojo, PHR

Responsibilities

Develop and implement the strategic vision and goals for the service lines with division leadership aligning with the overall organizational mission

Collaborate with executive leadership to define priorities and drive initiatives that enhance the quality of client management and practice support

Partner with service line leaders to scope and onboard new business within specialty services, including assessing systems and applications, tracking and communications, and operational outcomes specific to specialty workflows and reimbursement models

Oversee and manage the performance and development of all RCM processes related to specialty service lines, including but not limited to change capture, coding, billing, collections, denials, and appeals

Serve as a liaison between specialty services and other departments, fostering collaboration and communication across the organization to support specialty-specific revenue cycle needs

Plan, develop, organize, implement, direct and evaluate systems, processes and payor specific reimbursement mechanisms and billing requirements, contributing in the proactive identification of opportunities for revenue cycle improvement and enhancement

Engage with physicians and other stakeholders to gather feedback and address concerns related to specialty services’ revenue cycle performance, documentation, and reimbursement outcomes

Oversee coding auditing and education related to specialty-specific documentation, coding accuracy, and compliance requirements

Reviews, analyzes and interprets financial data to monitor progress towards established goals, identifies deterrents to success and implements improvements as necessary to enhance efficiencies and results within specialty service lines

Provides direction and coordination for the development and implementation of performance and quality improvement processes for the specialty services physician revenue cycle

Oversees resolution of escalated issues with third party payors specific to specialty services, including underpayments, appeals, and contractual discrepancies

Stays current on all payor regulations including managed care, Medicare, Medicaid, and other payor regulations that impact billing activities for specialty and procedure-based services

Manage revenue cycle operational team members assigned to specialty service line portfolios, ensuring expertise aligned to specialty complexity

Qualification

Revenue cycle operationsHealthcare regulationsFinancial reportingAnalytical skillsEHR systemsRevenue cycle technologyCoding certificationsEMR systemsData analytics toolsLeadership skillsSupervisory experienceCommunication skillsProject management

Required

In-depth understanding of revenue cycle operations across specialty services, including patient access, billing, collections, and compliance

Strong knowledge of healthcare regulations, payer requirements, reimbursement methodologies, and industry best practices

Expertise in financial reporting, budgeting, and performance metrics related to revenue cycle management

Exceptional leadership and strategic planning skills to drive operational efficiency and revenue optimization

Advanced analytical and problem-solving skills with the ability to interpret complex data and develop actionable insights

Superior communication and presentation skills for engaging executive leadership, physicians, and cross-functional teams

Proficiency in revenue cycle technology platforms, EHR systems, and data analytics tools

Ability to develop and implement long-term strategies that align with organizational goals and regulatory requirements

Ability to lead large teams, foster collaboration, and manage change in a dynamic healthcare environment

Ability to influence stakeholders and negotiate effectively to achieve financial and operational objectives

Ability to prioritize initiatives, allocate resources, and manage multiple projects at an enterprise level

1-2 years leadership experience and/or operations management experience

Minimum five (5) years of Hospital or Physician Practice Revenue Cycle management required

Bachelor's degree in Business Administration, Accounting, Healthcare Administration, Finance, or related field

Minimum of 10 years of experience in professional services and hospital coding, billing and collecting

Strong knowledge of various EMR systems including but not limited to: EPIC, eClinicalWorks (eCW), MedHost, Cerner, and Allscripts

Certification in one of the following: Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Clinical Documentation Specialist (CCDS), and/or Certified Professional Medical Auditor (CPMA)

Advanced computer skills required

Strong knowledge of health plan requirements

Previous supervisory experience