The Director, Revenue Cycle is a Full Time, Regular position working Monday-Friday at the Inland Imaging Business Center Downtown Spokane. May be eligible for a hybrid work schedule after training. This position may be filled as a Director, Revenue Cycle or Chief Revenue Officer based on candidate qualifications.
Summary: The Director of Revenue Cycle (DRC) directs and implements financial plans and strategies associated with radiology patient revenue realization for the enterprise. The DRC is responsible for enhancing and maintaining properly functioning revenue cycle processes by following industry best practices. The role has oversight of Revenue Cycle operations, including maintenance of the charge master (CM), strategic pricing review and recommendation, payer fee schedules, and payer contracting. The DRC actively participates in strategic and business unit planning and assists in the development of reasonable and thorough revenue projections for annual budgets and multi-year projections, as needed. The DRC leads third party contract negotiations and negotiates with governmental payers, as required. Critical responsibilities include the achievements of annual and periodic goals for significant indicators on revenue cycle performance.
General Description
Essential Duties/Responsibilities: The Director of Revenue Cycle manages a department that includes a large staff performing all aspects of Radiology patient billing services. The position manages the reimbursement operations while at the same time making process improvements. The position also operates within the context of the federal and state reimbursement regulations and guidelines, as well as those required by a variety of insurance companies as defined in their agreements and contracting guidelines. A significant responsibility is the enhanced use of information technology to support and improve the reimbursement function and the cash flow within the companies. Responsibilities include:
- Develops strategic plans and programs for Revenue Cycle (RC) team, oversees, monitors and reports on annual and monthly performance targets for RC compared to industry benchmarks for all enterprise locations including hospitals, clinics and imaging centers.
- Utilizing available business intelligence, analyzes RC trends and leverages information to develop solutions to optimize RC performance.
- Interacts with senior leadership at all locations with respect to RC performance including regular reporting of RC results.
- Assures monitoring of all revenue cycle services performed by outside vendors, such as statement processing, EDI vendors, Bad Debt agency performance.
- Analyzes enterprise-wide revenue cycle trends and provides insight into strategic implications.
- Ensures that all revenue cycle policies and procedures are adhered to and updated as necessary.
- Leads Radiology Billing Committee.
- Negotiates payer contracts for the enterprise.
- Reviews and monitors all payer contract performance and compliance and reimbursement requirements to ensure each payer is adhering to contract terms and conditions.
- Oversees contract management to ensure all contracts are current.
- Coordinates roll out of new contracts and assures appropriate staff are notified of relevant changes.
- Coordinates with the provider credentialing department to ensure data is accurate for new payers and new locations and to resolve credentialing data impacting claim processing.
- Works to optimize turnaround time from exam completion to payer acceptance at the provider and location level.
- Participates in the development of the annual revenue operating budgets for all locations.
- Oversees and ensures that all HIPAA and PHI policies are being followed within the RC team.
- Communicates and resolves reimbursement issues or changes to reimbursement and payer contracts.
- Coordinates/ interacts with many other departments in the enterprise in the successful execution of RC activities including: Patient Scheduling, Orders, Prior Authorization, Registration, Imaging Center Operations Management and IT Support departments.
General Duties/Responsibilities:
- Ability to maintain strict confidentiality within the Inland Imaging companies and Inland’s customers.
- Honest, pleasant manner and good personal hygiene.
- Free of alcohol and drug abuse.
- Valid state driver’s license and proof of insurance.
- Excellent communication and interpersonal skills.
- Detail oriented; ability to multi-task; organized and able to work in a fast paced environment.
- Demonstrates self-directed learning and participation in continuing education through professional journals, approved seminars, etc.
- Adheres to departmental standards and personnel policies by demonstrating professional demeanor in conduct and appearance.
- Follows company departmental standards and personnel policies by using good teamwork and communication skills to help identify concerns and solutions, assisting where needed to ensure a smooth functioning department.
- Follows all Health and Safety policies and guidelines of Inland Imaging and its partners depending on work location.
- Performs other duties as required by displaying team spirit and self-growth, accepting and performing other projects and responsibilities, and requesting other projects and responsibilities.
- Attendance is required for this position.
- Rotates to other shifts and locations as needed.
Supervisory Responsibilities: The position supervises a large staff including three direct report managers. The DRC is involved in providing advice and recommendations to the leadership team including advice related to front-end process improvements that will enhance the efficiency and effectiveness of reimbursement.
Advocacy:
1. Treats all clients with dignity and respect.
2. Provides excellent customer service.
3. Conforms to Joint Commission and HIPAA regulations.
4. Complies with PHI (Protected Health Information)
5. Demonstrates the Inland Imaging Core Values:
- Show We Care, Do The Right Thing, Maximize Individual Potential, Always Aim Higher
Qualifications: The requirements listed below are representative of the knowledge, skills and/or abilities of the work. Reasonable accommodation is made to enable an individual with disabilities to perform the essential functions.
- Education: Requires a Bachelor’s degree in business administration or a closely related discipline.
- Experience: Requires ten years of experience in relevant areas of accountability covering both governmental reimbursement, payer contracting, electronic billing and all aspects of revenue cycle management.
- Information technology skills: Working knowledge of information technology area as it relates to revenue cycle processes and procedures.
- Background Check:
o Must be able to pass a background check required by RCW 43.43.830-840 to work with children under the age of 16, developmentally disabled persons or vulnerable adults.o In order to comply with provisions set forth in Sections 1128 and 1156 of the Social Security Act, all new employees of Inland Imaging Business Associates will be checked against the LIST OF EXCLUDED INDIVIDUALS provided by the Department of Health & Human Services, Office of the Inspector General (OIG). Employees must not be included on this list.
- Drug Test: Eligible employees must be able to pass a post-offer, pre-employment drug test which includes marijuana.
Job Type: Full-time
Pay: $94,007.44 - $141,011.16 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Referral program
- Relocation assistance
- Retirement plan
- Vision insurance
Schedule:
Supplemental pay types:
Ability to commute/relocate:
- Spokane, WA 99204: Reliably commute or planning to relocate before starting work (Required)
Work Location: Hybrid remote in Spokane, WA 99204