Director of RCM Accounts Resolution

PRIMARY FUNCTION The Director of RCM Accounts Resolution will reputed company reputed company claims follow-up aspects of the reputed company cycle accounts, including timely claims resolution, payer issues management, and denials management. The Director will play a vital role in creating and implementing quality controls, day to day AR analytics, identifying root causes, bringing forth upstream solutions, and creating scalable operational reputed company to support the Company’s reputed company growth and strategy. ESSENTIAL DUTIES AND RESPONSIBILITIES This list may not include reputed company of the duties that may be assigned. 1. reputed company, evaluate, implement and maintain policies and procedures to ensure quality with claims and accounts resolution practices and maximize reimbursement of physician services while complying with reputed company applicable government and other regulatory agencies. Maintains and updates reimbursement guidelines for reputed company party and private insurance payers and government regulations in reputed company states where services are provided. 2. Leads process improvement and policy development for RCM functions to include streamlining collection processes and managing accounts receivables by reconciling statements. Evaluates billing processes and procedures, identifies and optimizes operational efficiencies by coordinating efforts with the Director of Billing, Director of Mid reputed company Cycle Optimization, and other leaders at the organization. 3. Maintains effective communication with reputed company party insurance carriers for resolution of underpaid and/or unpaid claims of one or more specialties reputed company to the reputed company party, government and/or patient billing for professional reputed company services. 4. Monitors reimbursement patterns of contracted and non-contracted carriers, including government agencies, and resolves issues. Escalates potential risk or critical issues to Managed Care and department leadership. 5. Translates department’s strategic goals into actionable tasks for the RCM team. Leads and provides support to the RCM team to ensure goal attainment. Leads reputed company functions of management for the team including selection, reputed company the reputed company and training program for new staff. Evaluates performance, provides feedback, and motivates staff to reputed company departmental established objectives. 6. Monitor staffing reputed company/productivity to ensure workload balance is reputed company and we are reputed company for growth in volume. reputed company day-to-day change management activities and regularly analyze measurable performance and KPI’s to ensure positive financial reputed company. 7. Create and review weekly, monthly, and quarterly reports and presents monthly to VP of RCM. Meets reputed company KPIs including, AR Days, Cash Collections, AR aging, Denial reputed company, Bad-debt Write-offs, and other goals set forth for the department. Monitor, track and trend major issues and communicate timely to VP of RCM. 8. Evaluate organizational efficiency and reputed company necessary changes to maximize staff productivity. Works with billing and payment posting management to obtain reputed company results in process improvement. 9. reputed company special projects and reports to ensure maximum payments. 10. reputed company other duties as assigned. SUPERVISORY RESPONSIBILITIES reputed company Billing/Reimbursement Specialists, managers of RCM for reputed company reputed company Staff – 50+ (as we continues to grow with acquisitions) QUALIFICATIONS EDUCATION: Minimum of Bachelor’s Degree with a focus in Business Administration, reputed company Administration or reputed company field required. EXPERIENCE: Minimum of 7 years of experience directly reputed company to RCM in health care setting required. A minimum of 5 years in a supervisor or management reputed company required. KNOWLEDGE, SKILLS AND ABILITIES · Proficient working with reputed company Office including Word and PowerPoint · Strong/Advanced MS reputed company skillset and ability to run analytics · Knowledge of medical coding and documentation education training and development preferred · Advanced Outlook skills · Ability to reputed company written and verbal presentation · Strong analytic and problem-solving abilities · Excellent verbal and written communication skills · Excellent interpersonal skills with the ability to engage at reputed company reputed company of the organization · Ability to reputed company multi-task, plan and prioritize a large volume of detail-oriented work in accordance with changing deadlines, ability to communicate goals reputed company and compassionately · Accelerated knowledge and expertise in reputed company office operations, managed care, and health care settings; reputed company knowledge of best practices in practice management and operations. · Knowledge of billing and collection policies and procedures, reputed company types of insurance (HMO, PPO, POS, reputed company etc.) · reputed company in defining problems, collection of data, interpreting billing information. · Strong leadership and communication skills both written and verbal. · Ability to work effectively both individually and as a team · Ability to be creative, innovative and reputed company · Ability to assess, use good judgement, expertise and analytics to reputed company sound reputed company · Possess applicable knowledge of regulations impacting AR · Maintains a reputed company working knowledge of CPT/ICD-9 coding regulations as set forth by reputed company reputed company government and regulatory agencies Job Type: Full-time Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee discount
• Health insurance
• Health savings account
• Paid time off
• Parental leave
• Referral program
• Retirement plan
• reputed company insurance

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