Director of Revenue Cycle

Company: Advantia Health
Location: Arlington
Posted on: April 8, 2021

Job Description:

Advantia is transforming healthcare for all women - setting a higher standard of care and convenience while reducing unnecessary costs. Compassion and value inspire everything we do. We take time to listen, answer questions completely, and offer helpful technology between visits so that our patients are empowered and at ease. Alongside coordinated care, Advantia is pioneering care models that align incentives with the best interests of women and their families.Advantia is expanding quickly through organic growth and acquisitions, providing direct care through more than 200 providers across 60 locations, serving over 430,000 patients at our OB-GYN and coordinated specialist offices. Advantia also enables health plans, state health organizations, hospital systems, and employers to deliver high-value care through technology products.
Learn more at: The Director of Revenue Cycle drives and directs reimbursement/revenue cycle strategy and operations for all of Advantia's Practice's that operate within multi-state locations. The position is responsible to oversee the functions of the billing group to include the effective management and guidance of receivables. This position is also responsible to ensure that all billing and collections are in accordance with company policies and procedures, regulatory requirements and guidelines. This position works closely with Managed Care to ensure billing and collections are in accordance with contracted and negotiated agreements. The Revenue Cycle Director works closely with the corporate finance team to provide accurate documentation of accounts receivable reports, revenue analytics and roll forward of balances for all legal entities and the company.
Job Duties:

• Oversees the revenue cycle and receivables management operation for the CBO utilizing corporate resources to allow for maximization of revenue for NCP. Ensures compliance with all pertinent company and regulatory requirements, policies and guidelines.
• Supports the Accounts Receivable Accounting team by providing guidance and subject matter expertise, as needed, to establish effective and efficient functioning of the reimbursement function.
• Monitors all major issues impacting reimbursement operations and collections, ensuring appropriate actions are taken to address identified issues and providing guidance and expertise as necessary to ensure an effective and suitable resolution.
• Ensures appropriate personnel take prompt, decisive action to remedy operational and collection problems.
• Ensures all major third-party payer reimbursement issues are addressed and resolved appropriately and according to the established policies and procedures.
• Ensures management is informed regarding all major issues impacting the revenue cycle billing and collections.
• Ensures that accounts receivable trends are closely monitored and that the appropriate decisions and actions are taken promptly to remedy operational and collection problems.
• Ensures identified audit and compliance issues are addressed and corrected.
• Oversees the monitoring of bad debt reserves, contractual and write-offs.
• Monitors revenue cycle performance metrics to drive continuous improvement efforts in all areas of the revenue cycle providing regular updates to the CFO and Controller to ensure prompt attention to areas of concern.
• Contributes to the compliance with, and development and updating of, company and department standard operation policies and procedures by:
• Ensuring current knowledge of industry best practices and their applicability to NCP.
• Reviewing and auditing current practices and procedures on a continual basis and incorporating identified effective best practices into the standard operating procedures.
• Supports the CFO providing regular updates regarding the revenue cycle and collaborating to ensure the appropriate compliance and regulatory oversight for the reimbursement and billing functions.
• Provides input regarding revenue cycle operational and budgetary decisions.
• Develops and maintains external professional relationships with payers, professional associations, regulatory agencies, external auditors, vendors, and other healthcare organizations to monitor and influence external forces impacting company receivables and reimbursement.
• Coordinates with payor relations to provide payor issues and pertinent information to help drive the corporate payor strategies
• Other duties assigned
  Job Qualifications:
  
  • Bachelor's degree in a health-related field or business administration; MBA or advanced degree desirable
  • 10+ years of revenue cycle experience leading a central billing office
  • 7+ years of experience as a manager or senior manager
  • Knowledge and experience in revenue accounting and revenue cycle best practices
  • Analytical skills to interpret and report monthly revenue results
  • Ability to present financial data and payor reimbursement information to physicians and executive management
  • Strong ability to multi-task in a fast-paced environment
  • Well-organized with ability to prioritize
  • Strong organizational, written and oral communication skills
  • Managed care contracting knowledge
  • Attention to detail and problem-solving ability
  • General knowledge of the Centers for Medicare & Medicaid Services (CMS) regulations
  • General knowledge of Adobe PDF Pro, Excel, Word, PowerPoint and Outlook
    Work Location: Following the company's return to the office) this position will be based out of our Arlington, Virginia headquarters. Advantia Health is an Equal Opportunity Employer that is committed to global diversity: It's a place where good people want to work and customers want to continue to engage EOE M/F/D/V.

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