Director - Revenue Cycle

Role Summary

We are seeking an experienced and effective Director - Revenue Cycle to lead process improvement initiatives, RCM system optimization, and the implementation of automation throughout the RCM department. Key areas of responsibility include inter-department process improvement initiatives and project management, RCM system optimization and file maintenance, as well as data analytics. This role requires strong leadership skills, analytical abilities, extensive knowledge of healthcare billing practices and system implementations, and a commitment to process improvements.

Responsibilities

• Collaborate with RCM Directors to identify opportunities for process improvement initiatives, prioritize those initiatives, and execute on plans to achieve those improvements.
• Partner with RCM system provider (Xifin) to fully optimize the platform, create efficiencies for the broader RCM team, and implement automation.
• Develop and execute upon inter-departmental project and communication plans in preparation of organizational product launches and other new initiatives.
• Serve as a liaison between internal Caris IT development team and external system providers. Set proactive measures to ensure there are no interruptions to daily file transmissions and collaborate to update file parameters when required.
• Directly responsible for file maintenance activities within the RCM platform which includes Payor Maintenance, Fee Schedule entries, Consolidation rules, and other activities as assigned.
• Engage with RCM Directors to develop a training program for each functional team which will be utilized for continuing learning and new hire training.
• Manage Data Analytics group to ensure routine delivery of reporting, creation of new dashboards and scorecards, and the maintenance of existing reporting.

Qualifications

• Bachelor's degree in healthcare administration, business administration, or a related field or equivalent work experience.
• 8+ years of experience in medical billing/revenue operations in an Oncology or Laboratory settings, with at least 2 years in a supervisory or managerial role.
• Hands-on experience with file maintenance activities such as payor setup, fee schedule entries, and consolidation rules within an RCM platform, Xifin Preferred.
• Proficiency in data analytics tools and platforms, with the ability to create dashboards, scorecards, and custom reports.
• Familiarity with HIPAA regulations and other compliance standards related to patient data and healthcare billing.
• Demonstrated ability to troubleshoot system issues and proactively manage file transmission integrity across internal and external systems.
• Experience in mentoring and developing staff, including creating and executing training programs for new hires and ongoing education.
• Proven ability to manage multiple concurrent projects and prioritize tasks in a dynamic, fast-paced environment.
• Experience leading process improvement initiatives and implementing automation.
• Strong leadership, communication, and interpersonal skills, with the ability to effectively manage a team and collaborate with internal and external stakeholders.
• Excellent analytical and problem-solving abilities, with a focus on accuracy, attention to detail, and process improvement.
• Commitment to maintaining confidentiality and integrity in handling sensitive patient information.
• Familiarity with healthcare reimbursement methodologies and revenue cycle management principles.

Preferred Qualifications

• Master's degree in healthcare administration, business administration, or a related field preferred.
• Experience working in Oncology, Laboratory, or Diagnostic Services with a deep understanding of specialty billing and reimbursement models.

Physical Demands

• Must possess ability to sit and/or stand for long periods of time.
• Must possess ability to perform repetitive motion.
• Ability to lift up to 25 pounds.
• Majority of work is performed in a desk/cubicle environment.

Other

• Willingness to work shift work and overtime is required.
• Travel Required.
• Weekends/Evenings/Holidays: No.