The Director of Revenue Cycle Management (RCM) is responsible for leading the billing, verification, and coding teams and driving the strategies for collecting payment from insurance companies for participating physicians, as well as facilitating the appeals process, with the assistance of the various managers, directors, and practice executives.

Essential Duties: Oversees the daily performance of the billing department. Provides daily support, guidance, and expertise to billing staff. Initiates the appeals process as needed. Ensures claims are coded correctly, including all wrap claims. Maintains accurate records on accounts in the appeals process. Provides staff training on sending claims, posting payments and how to use the billing software. Provides support to staff regarding third-party payor questions. Completes the enrollment process for new physicians. Works with physicians to ensure PQRS and MIPS reporting and compliance. Works with the CFO to develop processes and procedures for the efficient and successful flow of information between the billing department and the participating physicians and operations. Executes upon key strategies and performance indicators to drive the collection of earned reimbursement. Implement and maintain policies and procedures to ensure the proper investigation and resolution of denied or rejected claims. Monitors billing compliance with all third-party payer regulations. Ensures that customer satisfaction is achieved through timely, professional, and courteous communication. Resolves complex physician or client issues in a timely manner. Promotes a team-oriented environment that fosters collaboration within and outside of the department. Maintains confidentiality in compliance with HIPAA regulations and ensures that the department remains compliant with all relevant regulations. Familiar with Medicare, Medicaid, HMO, PPO, all Managed Care, Workers Comp, Tricare Ensure sliding fees are followed and calculated annually (posted and internal EHR system) Works with billing staff to enter contracted rates into the billing system. Reviews contracts to ensure contract fees are entered correctly. May perform other duties as assigned. Qualifications: Bachelors Degree in a Healthcare, Quality Assurance, or related field required. An equivalent combination of education and experience may be considered in lieu of the degree. CPC, CPB, or similar certification is encouraged. The successful candidate must display a proven track record of revenue cycle management success. This individual should have a minimum of 10 years of work experience, with no less than 7 years in a FQHC healthcare organization. Prior group management experience highly preferred, FQHC experience is a plus.

Job Type: Full-time

Pay: $130,000 Annually

Benefits:

Health Insurance Dental Insurance Life Insurance Vision Insurance Paid Time Off (PTO) Eligible for Public Service Loan Forgiveness Schedule: Monday to Friday

Location: Two Locations

Benefit Conditions: A waiting period may apply

Westchester Community Health Center (copy)

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Director of Revenue Cycle Management