Vice President of Revenue Cycle Management jobs in United States
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Advocates · 18 hours ago

Vice President of Revenue Cycle Management

Advocates is a company focused on cultivating a diverse and welcoming community, and they are seeking a Vice President of Revenue Cycle Management to lead the strategic development and oversight of revenue cycle initiatives. The role involves collaborating with finance and service line divisions to optimize clinical and financial processes, enhancing revenue outcomes while ensuring compliance with regulations.

Addiction TreatmentCommunitiesElder CareHealth CareNon Profit

Responsibilities

Develop and execute a comprehensive revenue cycle strategy aligned with organizational goals, including clearly defined metrics to improve timeliness, accuracy and overall collection rates of claims
Direct all day-to-day revenue cycle functions, including claims submission, payment posting, and patient collections. Woth with service line leadership on optimizing registration, insurance authorization and verification
Collaborate with service line leadership on financial forecasting and revenue optimization
Utilize data-driven insights to identify trends, forecast revenue, and inform decision-making
Set, track, and report on key performance indicators (KPIs) such as days in accounts receivable (A/R), denial rates, and collection percentages to drive continuous improvement
Manage and negotiate contracts with commercial insurance carriers and government payers, such as Medicare and Medicaid, to optimize reimbursement rates
Build, train, and manage a high-performing revenue cycle team. Foster a culture of accountability and professional growth within the department
Ensure all RCM activities adhere to federal, state, and payer-specific regulations, including HIPAA. Identify and mitigate potential risks that could impact the organization
Develop and implement processes to identify root causes of denials, prevent future rejections, and manage appeals to minimize revenue loss
Develop and ensure implementation of policies, guidelines, and procedures as they relate to the RCM process
Monitor effectiveness of activities, ensuring that outstanding authorizations, billings, postings, collections and accounts receivables are within established time limits and that bad debt is within industry standards by conducting routine concurrent and retrospective audits
Enhance and standardize workflows. Develop and implement billing practices by leveraging technology to automate, and standardize processes
Conduct regular meetings with the team to ensure implementation of all RCM plans, programs, and projects are adhering to deadlines
Conduct regular meeting with the Enterprise Applications Team to support refinement and development of third party billing software system
Design/develop training programs for development of technical competencies of the team
Manage the authorization/billing/collection staff in handling patient/payer relations and handles complex complaints and issues
Stay abreast of third-party payer billing guidelines and communicate these changes to all interested parties
Ensures all service fee schedules are correctly loaded in the system, billed correctly and reimbursed at the rates agreed
Attends and actively participates in supervision and staff meetings
Adhere to all principles related to the Advocates Way
Ensure that clients are treated with dignity and respect in accordance with Advocates’ Human Rights Policy
Performs all duties in accordance with agency’s policies and procedures
Strictly follow all agency Performance Standards

Qualification

Revenue Cycle ManagementHealthcare billing experienceElectronic Health RecordsHealthcare Financial ManagementBehavioral health billingTeam managementAnalytical skillsLeadership skillsInterpersonal skillsCommunication skills

Required

Bachelor's degree in healthcare administration, finance, or a related field, or equivalent experience
Minimum 15 years of healthcare billing experience, including at least 10 years managing teams of individual contributors and managers
Strong, in-depth knowledge of revenue cycle management principles and practices, including, collections, managed care products, regulatory compliance, payer credentialing, and financial reporting related to behavioral health billing
Extensive knowledge of behavioral health billing processes
Strong experience with electronic health records (EHRs) and integrated RCM modules
Demonstrated success working with diverse payer mixes, with a focus on Medicaid and Managed Medicare payers, and varied reimbursement methodologies
Proven experience supporting new product launches and integrating associated billing requirements
Strong organizational, leadership, and interpersonal skills
Ability to analyze complex workflows and implement process improvements that enhance efficiency and outcomes
Demonstrated ability to hire, mentor, and develop high ‑ performing teams
Excellent written and verbal communication skills with the ability to engage all levels of internal and external stakeholders
High energy, strong interpersonal presence, and ability to work effectively both independently and as part of a team
Proven ability to delegate, prioritize, and meet strict deadlines
Strong analytical and organizational skills with the ability to apply varied decision ‑ making frameworks
Must be able to perform each essential duty satisfactorily

Preferred

Industry certifications, such as those through Healthcare Financial Management Association, the American Health Information Management Association, or the Academy of Professional Coders, preferred

Company

Advocates

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Advocates is a non-profit organization that provides addiction recovery, care management, and developmental services to the community.

Funding

Current Stage
Late Stage

Leadership Team

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Keith Neal, MBA, MHL, CHFP, CRCR
Executive Vice President & Chief Financial Officer
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Regina Marshall
Chief Operating Officer
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Company data provided by crunchbase