Revenue Cycle Director

The following statements are intended to describe the general nature and level of work being performed.
They are not to be construed as an exhaustive list of all duties and responsibilities required of personnel so classified.
Position Summary: This position oversees all steps in the revenue cycle management process used to track the revenue from clients from the initial appointment or intake to final payment.
The Revenue Cycle Director is primarily responsible for overall revenue integrity via the EHR system and supports all Clinics and staff in relation to charging mechanisms and triggers, ensuring clean handoffs between Clinics and revenue cycle, and denials management.
The position must continually keep abreast of regulation changes from all government and other payer updates.
Further the position must lead all respective areas in charge capture and improvements for ensuring the highest level of efficiency, integrity and compliance within our revenue cycle operations.
Core Duties and Responsibilities: Receive billing reports from services and enter billing information to produce billing forms to bill Medicare, private insurance or clients/responsible party, or to bill electronic Medicare as appropriate.
Oversee Billing and Quality Assurance [QA] Teams to ensure consistent communication, knowledge, and implementation of Los Angeles County Department of Mental Health [LACDMH] Contract billing requirements.
Maintain client data received from services in computer and update as necessary.
Maintain all financial records received from projects in files on all clients as appropriate and update computer database as necessary.
Follow up with Clinic management in person or by telephone regarding problems with bills or accounts.
Be available for phone consultation to Clinic staff, clients, agencies, payors and contract agencies.
Verify payments are received as billed.
Follow up with LACDMH, Medicare, Medical and insurance companies regarding problems or denials, by phone or letter as appropriate.
Work to resolve Denied CalPM reports, 277 Critical Error Reports, Denied MSO, SIFT reports as assigned.
Prepare monthly activity and accounts receivable reports and forward to appropriate personnel.
Manage all systems for efficient and effective work efforts.
Communicate to Billing and QA team and other collaborators to stay informed of payer and/or regulatory updates, and create action plans to accommodate changes as needed.
Monitor and manage charging workflows and reports, in coordination with Revenue Cycle and Clinical departments to mitigate revenue leakage and optimize efficiency.
Prepare and deliver departmental summaries that pinpoint root causes of charge/billing errors and conceptualize process changes for Revenue Cycle and service leaders.
Engage collaborators to facilitate educational and workflow/process opportunities identified by team to improve documentation, billing and clinical operations.
Continually develop processes, policy procedures and controls to drive revenue integrity.
Supervises staff, assigns work, and counsels/disciplines if necessary.
Comply with all company policies and procedures as applicable.
Other duties as assigned.
Minimum Education and Experience Preferred: Healthcare Revenue Cycle leadership experience preferred in not-for-profit and/or government environments.
Experience with billing Medicare, insurance and private clients.
Experience with ICD 9 and CPT codes.
Knowledge of Medi-Cal system.
Knowledge of CalAIM requirements is a plus.
Experience with managing revenue cycle processes including Medicaid and Medical eligibility, health information management and billing, and charge capture processes.
Experience working with mental health consumer billing a plus.
Experience responding to government and financial Audits a plus.
Bachelor degree or above preferred.
Licenses/Certifications: Valid California driver?s license, current automobile insurance, and eligibility to drive for the Company.
Knowledge, Skills and Abilities: Ability to perform in a positive, courteous, flexible and adaptive manner.
Able to exercise independent judgment and initiative.
Computer literate and experienced with computer programs such as Microsoft Office Word, Outlook and Excel.
Must be able to communicate clearly, both orally and written.
Physical Requirements: See well enough (with or without corrected vision) to read fine print, hand-written materials, and a computer screen.
Speak and hear well enough (with or without assistive device) to converse in person and by telephone.
Finger, handle, feel, and reach with hands and arms, including ability to use a computer keyboard.
Have the mobility (with or without assistive device) to stand, sit, crouch, and move from one work area to another.
Have the strength to lift, carry or push office equipment and supplies used in normal job functions up to 20 lbs.
Stamina to effectively perform work activities.
Pay Range: $85,000 - $105,000/Year (Determined by Experience and Qualifications) Policy Statement: Enki Health Services, Inc.
is an equal opportunity employer with a standing policy of nondiscrimination.
This means that all qualified persons are accorded an equal opportunity for employment or promotion without regard to race, color, creed, religion, sex, gender, gender identity, gender expression, sexual orientation, marital status, registered domestic partner status, age, pregnancy, national origin, ancestry, physical or mental disability, medical condition, genetic information, military and/or veteran status, or any other basis protected by applicable law.
Enki will comply with all fair employment laws and will take affirmative measures to eliminate or prevent illegal discrimination.
It is the policy of Enki that positive action be taken to insure that members of protected classes have an equal opportunity for all jobs.
Enki will comply with all requirements of the Americans with Disabilities Act (ADA).