Director of Revenue Cycle
Company: Golden Valley Health Centers
Posted on: June 21, 2022
The Director of Revenue Cycle is responsible for ensuring
consistency and quality of the coordination of revenue cycle
operation, procedures, and best practices for charge capture,
billing, payment posting, collections, and follow up, denials
management, billing audits, revenue cycle reporting and all other
aspects of community health center revenue cycle. Manage the
activities of the centralized billing staff through daily
supervision while overseeing all billing, coding, and accounts
receivable functions.This position will work at our Frenso
site.Schedule is Monday - Friday, 8:00am - 5:00pmEssential Duties
- Organize and direct all activities to ensure control and
management of patient accounts receivable, including charge
capture, claims production, claims scrubbing, billing, collections,
customer service, denial management, cash posting, and follow-up on
- Ensure accurate and timely submission of all claims, and timely
- Organize work and set priorities for direct reports and for the
department. Ensure that direct reports and their staff are meeting
our patients' expectations about quality, service and
- Collaborate and communicate with multiple levels of management
across the organization.
- Establish and maintain all billing and financial data,
including medical billing code tables, rate schedules and payer
- Promote data-driven decision-making in a culture of high
performance and continuous improvement that values learning and a
commitment to productivity and quality assurance.
- Analyze significant financial trends and events to share
relevant findings with key stakeholders to drive challenging
- Oversee the development and maintenance all reporting processes
for key performance indicators and will analyze and redesign
processes as needed to improve key performance indicators.
- Analyze reimbursement from all sources, including carrier
reimbursement exception reporting and follow up pending claims
analysis and denials management.
- Assure maximization of cash collections through diligent and
timely monitoring of all open accounts receivable balances.
- Develop, implement, and update training, policies and
procedures to improve the functionality of all steps within the
revenue cycle, and improve revenue cycle performance. Ensures
consistent quality and manages all billing operations, including
hiring, orientation, training, development, coaching, corrective
actions, and timely performance reviews for direct reports. Lead
process reviews to improve quality, efficiency, effectiveness of
revenue cycle activities.
- Collaborate to ensure proper enrollment of GVHC and compliance
with individual providers for all public and private insurance
- Participate in patient contract negotiations; ensure proper
implementation of patient contract programs to ensure compliance,
eligibility, service delivery, billing functions and maximize
- Maintain and foster excellent payer relations with key fiscal
intermediaries and government oversight agencies.
- Provide departmental direction and supervision, including a
vision for future direction of revenue cycle activities.
- Ensure the organization complies with all laws and regulations
related to the revenue cycle, including coding and HIPAA.
- Lead the process to systematically evaluate, monitor and report
on regulatory compliance related to the revenue cycle.
- Establish and utilize an account denial and/suspense process to
monitor and minimize payer denials and suspensions.
- Coordinate audits related to billing, coding and patient
- Monitor credit balance reports to ensure accurate and timely
- Monitor and ensure compliance with applicable timely refund
requirements, such as CMS 60-day rule.
- Other projects or duties as assigned.Physical Demands
- Lift up to 30 pounds occasionally and push up to 50 pounds (on
wheels) on rare occasions.
- Must be able to hear staff on the phone and those who are
served in-person, and speak clearly in order to communicate
information to clients and staff.
- Must have vision with or without lenses that is adequate to
read memos, a computer screen, personnel forms and clinical and
- Must have high manual dexterity.
- Must be able to reach above the shoulder level to work, must be
able to bend, squat and sit, stand, stoop, crouching, reaching,
kneeling, twisting/turning, fingering and feeling.Work Environment
The physical environment requires the employee to work indoors,
primarily in an office setting. The noise level inside is quiet to
average. Use of general office equipment is required on a daily
basis. Travel may be required at times.Education/Experience
- Excellent working knowledge of patient financial service
operations with focus on community health centers, public
insurance, and managed care.
- Knowledge of all functional areas of revenue cycle, including
registration, billing, charge capture, AR management, bad debt
analysis, utilization review, managed care contracting terms,
health information management, information systems, State and
Federal billing regulations; demonstrated experience in diagnosing,
evaluating and developing corrective actions for problems within
revenue cycle operations.
- Well-versed with all federal, state and HIPAA privacy
regulations with thorough knowledge of CPT and ICD-10 coding
protocols and procedures.
- Strong computer skills including experience with EPIC,
Microsoft Excel, Word, Outlook.
- Demonstrate strong organizational and leadership skills in a
fast paced, growing environment.
- Handle confidential materials and information in a professional
- Ability to effectively influence change; forge effective
working relationships with direct reports, members of leadership
team, key executives, external government and non-government
- Attention to detail and capability to apply discretion and
sound judgment in managing complex processes, decisions and
handling sensitive information with awareness of impact to
- Demonstrate effective communication.
- Demonstrate experience, creativity and evaluative thinking
skills to assess problems and find solutions;
- Exemplify responsible, ethical and honest behavior at all
- Demonstrate the ability to present facts clearly which leads
others to share their perspectives and ultimately reach
- Develop good relationships with individuals internally and
- Prioritize and balance workload on short and long-term company
- Valid CA Driver's License, reliable transportation, acceptable
driving record, and liability insurance.Education/Experience
- High school diploma or equivalent.
- Bachelor's degree in finance/accounting, business
administration, healthcare administration/management, or related
- Master's degree in business administration, or related field,
- A minimum of five (5) years of experience managing a staff of
professionals in the revenue cycle.
- Billing Director experience in a Community Health Center,
Keywords: Golden Valley Health Centers, Fresno , Director of Revenue Cycle, Executive , Fresno, California
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