Community health is about more than just vaccines and checkups. It's about giving people the resources they need to live their best lives. At Neighborhood, this is our vision. A community where everyone is healthy and happy. We're with you every step of the way, with the care you need for each of life's chapters. At Neighborhood, we are Better Together.
As a private, non-profit 501(C) (3) community health organization, we serve over 350k medical, dental, and behavioral health visits from more than 77k people annually. We do this in pursuit of our mission to improve the health and happiness of the communities we serve by providing quality care to all, regardless of situation or circumstance.
We have been doing this since 1969 and it is our employees that make this mission a reality. Regardless of the role, our team focuses on being compassionate, having integrity, being professional, always collaborating, and consistently going above and beyond. If that sounds like an organization you want to be a part of, we would love to have you.
The Revenue Cycle Director will oversee the billing department for the entire organization. This role will provide leadership, establishes procedures, coordinates workflows, and assigns priorities to ensure overall effectiveness and efficiency of the department and eliminates or minimizes risk for the organization. Additionally, this role will ensure leadership for a properly functioning and regulatory compliant revenue cycle process. This is a hybrid position, expected to commute to our Escondido office at least 1 day/week.
Responsibilities
Provides functional direction to assigned staff; schedules assignments, coordinate workflows and assigns priorities
Responds to complaints, problems, and overall needs affecting revenue
Reviews and monitors job performance of assigned staff
Works with the Senior Director of Revenue Cycle and Analytics to maximize revenue, develop effective workflows and action plans, and ensure optimization of current technology
Develops reports and analyses to monitor revenue and quality from A-Z on revenue cycle activities
Establishes and assures implementation for the Billing department policies and procedures
Implements appropriate changes based on audit findings, payer needs, compliance standards, and billing analysis
Develops and implements performance goals and training needs for the Billing department
Develops action plans on reported coding and/or reimbursement trends and issues that have an impact on the financial result, site needs, and internal workflows
Manages relationship between the Billing department, operations staff, providers, and Learning and Development team to ensure appropriate training and performance standards are met to achieve success in areas with impact on the revenue cycle
Partners with front desk supervisors, clinical site supervisors, and/or site managers to assure patient registration, insurance capture, and collection activities are optimized
Develops an effective and functional knowledge of the PM system builds and other related software to ensure overall optimization of workflows
Reviews contract changes with Senior Director of Revenue Cycle and Analytics to implement compliance with updates/changes, additions, and termination of payers, coding issues, and/or reimbursement issues
Oversees and implements training in-services and developments for front desk staff on functional areas and their impact on revenue cycle performance measures, including cash collections, proper insurance verification and/or enrollment for patients with public and/or private insurance
Oversees the provider enrollment and credentialing process for the organization
Serves as in-house billing expert and ensures HIPAA, corporate compliance, OIG, and industry billing standards are adhered to
Performs and reviews analyses on trends with payer sources and denials to assist with development of site staff
Connects with varying levels in the organization and create an environment where solutions are created that result in benefits to all parties
Keeps informed of organizational activities/programs, provides oversight and leadership for implementation, and promotes mission and goals
Qualifications
Education/Experience
Bachelor's degree in business, health, management or related field and eight years' experience in a community health care setting or equivalent combination of education and experience required; 10 years preferred
Experience with medical third-party billing and payment and regulation management for a multi-site provider required
Five years' experience in management role required.
Additional Qualifications (Knowledge, Skills and Abilities)
Excellent working knowledge of patient financial service operations, managed care plans, and all functional areas of the revenue cycle
Excellent verbal and written communication skills, including superior composition, typing and proofreading skills
Ability to interpret a variety of instructions in written, oral, diagram, or schedule form
Ability to provide work direction to assigned personnel thorough knowledge of systems and procedures
Ability to interact effectively with supervisors and other staff
Ability to successfully manage multiple tasks simultaneously
Excellent planning and organizational ability
Ability to work with highly confidential information in a professional and ethical manner
Salary range: $158,811.56-$194,103.02 depending on experience.