The Acacia Network, a progressive community-based organization located in the Bronx, offering Primary Care and Behavioral Health programs, seeks an Assistant Director of Revenue Cycle.
The Assistant Director of Revenue Cycle is responsible for the management of the revenue cycle department. Understands managed care, state and federal government, commercial and self-pay accounts receivables and manages relationships with billing vendors. Manages assigned staff and resolves issues that may impact billing and collections. Collaborates with other departmental leads to ensure that productivity and cash collection benchmarks are established and maintained. Seeks and suggests performance improvement and revenue enhancements opportunities and is considered a subject matter expert on utilizing available tools to optimize revenue.
Accountable for oversight of staff training on systems use, reports and software tools departmental-wide. Establishes and monitors key performance indicators necessary to measure staff performance, audits and negotiates settlements with managed care payers. Provides analytic support and proposes solutions to client departments on all matters pertaining to dental and medical revenue cycle needs.
Organizes and directs staff to maximize efficiency of operation throughout the department;
Ensures that all billing EDI files are submitted correctly on a timely basis;
Ensures that all payments are posted accurately and on a timely basis;
Manages all third party [including state and federal] billing audits;
Manages the development and performance of all billing staff and ensures their understanding of all billing aspects of the accounts receivable and revenue cycle process;
Ensures proper follow-up of claims, denial tracking, under-payment resolution in a timely manner, refund management, and appeal filings;
Performs root cause analyses and creates and implements solutions sets from denial trending activity;
Evaluates current and future staffing needs and plays an active role in the hiring process as staffing needs demand;
Conducts annual performance appraisals for all staff in a timely manner. Responsible for staff mentorship, development and training and takes disciplinary actions according to the Acacia Network, Inc. guidelines as necessary;
Identifies new revenue opportunities and meets and/or exceedsrevenue collection targets;
Assists in modeling revenue projections and performs monthly, quarterly, and annual reporting and forecasting;
Downloads and analyzes data from third party and publiclyavailable sources;
Identifies and manages revenue related performance improvement projects from inception to implementation;
Maintains and develops as needed written departmental policies and procedures with revenue cycle and billing system implications;
Promotes culture of teamwork, commitment and accountability;
Ensures that all staff conforms to all applicable Article 28, 16 OPWDD, 31, 32, HIPAA, billing compliance and safety policies and guidelines;
Keeps apprised of rules and regulations affecting coding and reimbursement and assumes responsibility for self-development;
Escalates any issues as appropriate and advises senior leadership on matters pertinent to revenue optimization; and,
Performs all other duties and responsibilities as assigned.
Candidate must possess:
In depth knowledge of federal, state, managed care reimbursement, regulatory provisions, policy development, and governmental audits;
Familiar with insurance billing, collections and eligibility as it pertains to managed care, state and federal government, commercial and self pay reimbursement concepts;
A bachelor's degree in Business Administration, Health Sciences Administration, or a related discipline, plus 5 years of related experience in a leadership position;
Experience with APG’s and behavioral health billing is required along with excellent analytical and communication skills (written and verbal) and strong people management and team working skills;
Excellent organizational and time-management skills and the ability to work independently and handle multiple tasks simultaneously; and,
Proven track record of success in revenue cycle and operations management.
Strong management/organizational skills;
Able to build relationships and direct diverse groups of individuals at all levels through influence and persuasion;
Ability to meet deadlines and lead projects from inception to successful implementation;
Advanced computer skills (Word, Excel, PowerPoint);Ability to work under pressure, undertake multiple tasks as required;
Knowledge of NextGen, SMART, ADL is a plus;
As one of the paramount not for profit corporations in the country, we offer the chosen candidate, a multitude of benefits, including comprehensive full health care package, disability, life insurance, coupled with a generous vacation and pension plan and flexible schedules. E.O.E. M/F