Position Title: Director – RCM Reporting, Systems and Analytics
FLSA Status: Exempt
Type of Position: Full-time
Department Name: Operations
Reports To: Chief Operating Officer
Direct Reports: None Currently
The Director – RCM Reporting, Systems and Analytics is responsible for development and reporting for Operations Department and Customer Key Performance Indicator (KPI) Reports, routine and ad hoc reporting and analysis of key trends in Customer’s KPIs including recommendations for improvement and generation of monthly billing reports. This position is also responsible for coordination and scheduling of system activities to improve/correct systems within the revenue cycle department including testing, training, process change documentation, and reporting on these activities.
ESSENTIAL FUNCTIONS OF THE JOB
- Communicates with clients’ software vendors and IT department on a regular basis regarding systems issues.
- Identifies system resources available for enhanced improvement/performance and to accommodate changing requirements in payer contracts.
- Ensures the timely preparation of client reports to the administrative/management team regarding the financial performance of the billing department.
- Works with the Director of Operations to document and maintain optimal workflows for revenue cycle billing and collection activities within the revenue cycle.
- Works with the Director of Operations and RCM Managers to identify process improvement opportunities, develop proposals for implementation, and identify stakeholders in other departments needed for implementation.
- Assists the billing and management team in accomplishing set fiscal performance goals.
- Appropriately represents the organization at both internal and external functions. Attends appropriate client meetings and conferences.
- Responsible for taking large sets of often complex data and summarizing the information to draw meaningful business conclusions that help RCM Leadership identify areas for improvement.
- Monitor performance for KPI’s to discover lowest level root cause deficiencies and process efficiencies to maximize your revenue.
- Provide deep-level visibility into AR inventory and financial performance in order to increase collections and reduce days in AR.
- Quantify and assess the financial impact of contracts to strengthen and protect revenue streams and pinpoint service line opportunities.
- Deliver crucial information to help refine day-to-day processes through trending of denied amounts, zero paid and partial paid claims over total number of remits, and exposure amounts aggregated by different denial attributes.
- Ability to work independently to provide technical expertise in identifying, evaluating, and developing systems and procedures that meet user requirements.
- Work with development team to design and develop high performing data solutions which meet the needs to satisfy the Business Intelligence (BI) requirements.
- Design creative BI components for the delivery of dashboards, scorecards, delivered reports, ad hoc queries, extracts, and analytics using the MS Suite of tools including PowerBI, SQL, as well as other platforms.
- Responsible for maximizing the collection of medical services payments and reimbursements from patients, insurance carriers, and guarantors.
- Responsible for monitoring aged accounts and verifying appropriate collections procedures are being followed.
- Responsible for insurance eligibility processes, charge processing, claim submission, payment processing, collections and accounts receivable management, denial management, reporting and analysis.
- Regularly provides upper management with revenue cycle status including reports, metrics, and presentations.
OTHER DUTIES AND RESPONSIBILITIES OF THE JOB
- Provide administrative support to COO and CEO.
- Performs other duties as assigned.
SKILLS AND ABILITIES
- Communication – must possess excellent verbal and written communication skills.
- Analytical – must be able to research, analyze, interpret, and communicate simple and complex analytical data.
- Relationship building – must be able to build rapport with internal and external customers to support the organization’s mission and vision.
- Teamwork – must be able to work well with internal and external customers.
- Autonomy – must be able to work with little supervision or direction.
- 5-10 years healthcare experience preferably in a multi-specialty group or FQHC setting.
- 2-3 years in a reporting and analytics role.
- 2-3 years experience with extracting data utilizing SQL queries and other data extraction tools.
EDUCATION / CERTIFICATION REQUIREMENTS
- Bachelor’s degree from an accredited institution – required.
- MBA or Master’s degree in Health Administration or Finance- preferred.
PHYSICAL REQUIREMENTS ESSENTIAL TO PERFORM THE DUTIES OF THE JOB
- Frequently remains in a sitting position at a desk to perform duties.
- Frequently communicates with co-workers, customers, and contractors/vendors in person, on the telephone, and on the computer.
- Frequently works in a well-lit room.
- Frequently views the computer to perform duties.
- Frequently uses the computer with fingers and hands for documentation and communication.
- Occasionally stoops, bends, or kneels.
- Occasionally exposed to outside elements when traveling for business.
- Occasionally required to push and/or pull objects.
- Occasionally lifts and/or carries objects weighing up to fifty (50) pounds.
To apply send your resume to firstname.lastname@example.org.