Skilled Healthcare Facility -
Job Title: Director of Revenue Cycle Management
Department: Revenue Cycle
Reports To: Controller
Location: New Hyde Park, NY
Rate: $140,000-$160,000 annually
Employment Type: Full-Time
A long standing company in the healthcare industry for over 40yrs dedicated to providing exceptional health care services tailored to meet the unique needs of each individual we serve. With a rich history of experience, our team is comprised of highly trained and compassionate professionals who are committed to delivering the highest standards of care.
Position Summary:
The Director of Revenue Cycle Management (RCM) is responsible for overseeing all aspects of revenue cycle operations for a multi-state Home Health Company with Certified and Licensed operations. This role focuses on maximizing revenue generation, streamlining billing and collections processes, and ensuring compliance with regulatory requirements. The Director will lead a team responsible for billing, coding, collections, and account reconciliation, working to ensure efficient workflows and accurate financial reporting.
Key Responsibilities:
Leadership & Strategy:- Develop and execute strategies to optimize revenue cycle performance, including billing, collections, denials management, and accounts receivable (A/R) processes.
- Lead and manage the RCM team, including training, performance evaluations, and staff development. Support the build of the department where gaps exist.
- Collaborate with executive leadership to establish revenue cycle goals and provide regular updates on key performance indicators (KPIs).
2. Billing & Collections:
- Oversee the complete billing and collections process, ensuring accurate and timely submission of claims to Medicare, Medicaid, private insurers, and other payers.
- Monitor and manage accounts receivable, ensuring timely follow-up on unpaid claims and reducing A/R aging.
- Ensure prompt and effective denial management, with a focus on reducing the denial rate through accurate coding and proactive issue resolution.
3. Data Analytics & Reporting:
- Analyze financial data and provide regular reports on key metrics, such as days in A/R, cash flow, collection rates, and claim denials.
- Identify trends and areas for improvement in revenue cycle performance and recommend actionable solutions.
- Utilize advanced analytics to forecast revenue and monitor changes in payer behavior.
4. Process Improvement:
- Continuously evaluate and improve revenue cycle processes, ensuring efficiency, accuracy, and the use of technology (e.g., electronic health record (EHR) systems, billing software).
- Work with IT and other departments to implement automation tools that enhance RCM processes and reduce manual workloads.
5. Team Development:
- Lead, mentor, and develop the revenue cycle team, ensuring professional growth and adherence to best practices in revenue cycle management.
- Foster a culture of accountability and performance within the RCM department.
6. Payer Relations:
- Maintain relationships with insurance payers including dispute resolution.
- Stay current with changes in reimbursement policies, regulatory requirements, and industry trends to ensure compliance and optimize reimbursement opportunities.
7. Compliance:
- Ensure adherence to all regulatory guidelines, including Medicare/Medicaid billing rules, HIPAA, and state/federal laws governing home health services.
- Conduct internal audits and monitor compliance with established billing and coding practices to prevent fraud, waste, and abuse.
- Implement corrective actions and process improvements to address audit findings or regulatory changes.
Qualifications:
- Bachelors degree in Finance, Healthcare Administration, Business, or a related field (Masters degree preferred).
- Minimum of 5-7 years of progressive leadership experience in revenue cycle management, preferably in home health or healthcare.
- In-depth knowledge of Medicare/Medicaid billing, insurance payers, and regulatory compliance related to home health services.
- Strong financial acumen with experience in accounts receivable management, revenue optimization, and forecasting.
- Understand cash reconciliation and what the claim landscape looks like including denial management.
- Proven ability to lead and motivate teams to achieve high performance.
- Excellent communication and relationship-building skills.
- Experience with revenue cycle software systems (e.g., EHR, billing platforms). Experience with MatrixCare and/or HHA Exchange is a plus.
Skills & Competencies:
Strong leadership and management abilities.
Analytical thinking and problem-solving skills.
Attention to detail and ability to manage multiple priorities.
Knowledge of healthcare reimbursement methodologies and regulations.
Proficiency in relevant software applications (e.g., Excel, billing software, EHR systems).
Work Environment: Office environment
May require occasional travel to branch locations, conferences, or payer meetings.