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Director of Revenue Cycle

Job Summary: Director, Revenue Cycle Management - Front End
The Director, Revenue Cycle Management - Front End, will lead the front-end revenue cycle processes (patient registration, insurance verification and eligibility, patient responsibility, authorizations) that lead to more successful financial outcomes and an improved patient experience.
The role leads the front-end cross-functional team in supporting all revenue cycle activities (coding and billing) acting as a resource to inform staff on matters pertaining to the front-end revenue cycle. This role will partner closely with the call center, clinical and coding, and back-end billing teams to ensure processes are in place to achieve a clean claims rate and continued patient satisfaction. This position will report directly to the Chief Financial Officer.

Duties and Responsibilities:

  • Front-ended revenue cycle process ownership, including but not limited to: insurance verification, patient registration information, defining/documenting front-end policies and procedures, collection of patient and insurance data in EMR and billing, and partnering with call center.
  • Work closely with the Growth team on strategies to identify insurance information for new patients
  • Expected to engage verbally with senior population to ensure a positive patient financial experience
  • Co-develop tools and dashboards that are regularly reviewed to ensure performance targets are met for core Front End KPI metrics
  • Partner with mid-cycle and back end on the end-to-end continuum for clean claims submission and managing claims rejections/denials of coordination of benefits, coverage dates, and place of service
  • Work with 3rd party vendors to coordinate and monitor all Eligibility/Benefits, Pre-Certification Utilization Review, and outcomes for medical necessity
  • Support Revenue Cycle Compliance Committee by representing the front end at meeting
  • Coordinate with internal and external customers to obtain all information needed to be based on medical criteria from the healthcare teams, insurance, and customers to obtain insurance authorization
  • Performs and promotes interdepartmental integration and collaboration to enhance the continuity of care for patients
  • Assists with identification of continuously improving the digital health experience for both patients and the provider community
  • Maintains professional relationships with internal and external customers while identifying opportunities for improvement.

Education and Experience:

  • Five years experience in data analysis, healthcare EMRs, and billing, preferably in digital health; EPIC experience is a plus
  • Demonstrated knowledge of Healthcare reimbursement/collections, medical billing, ICD10 coding, and state and federal regulations, with a strong knowledge of the collections process
  • Preference for revenue cycle functions in physician-based services; in both business office, clinical, and utilization management departments
  • Comprehension and ability to navigate CMS and commercial payer requirements to determine medical necessity
  • Excellent verbal and written communication skills for patient financial clearance interactions and internal Health System stakeholders
  • Experience managing cross-functional teams and communication
  • Strong analytical and problem-solving skills, effectively thinking big picture while able to drill down into the details


OTHER REQUIREMENTS

  • Smart Phone
  • Remote Workstation
  • Standard Windows PC
  • Internet Access with DSL or Cable
  • VPN compatibility
  • Printer/Fax


SALARY AND BENEFITS

  • Paid Time Off and Sick Time
  • 401K
  • Medical, Dental, Life, and Long/Short term disability Insurance
  • Paid Association Dues Paid
  • Educational Benefits



AMN Healthcare is an EEO/AA/Disability/Protected Veteran Employer

We encourage minority and female applicants to apply.

AMN Healthcare is committed to fostering and maintaining a diverse team that reflects the communities we serve.

Our commitment to the inclusion of many different backgrounds, experiences and perspectives enables our innovation and leadership in the healthcare services industry.

Apply today and one of our team members will be in touch to help you find the role that best fits your skills and goals.

Benefits

Becoming an AMN Healthcare nurse gives you the incredible opportunity to explore new cities, gain critical nursing career experience, and earn a highly competitive salary-but the perks don't stop there. There are many additional benefits to enjoy through travel nursing jobs, including:

  • Premium health benefits for you and your family
  • Access to the largest network of facilities and providers in the country
  • Industry-leading clinical team support
  • Licensure assistance
  • 401k matching
  • Free CEUs



About the Company

At AMN Healthcare, we strive to be recognized as the most trusted, innovative, and influential force in helping healthcare organizations provide quality patient care that continually evolves to make healthcare more human, more effective, and more achievable.

Director of Revenue Cycle

Los Angeles, CA
Full Time

Published on 08/10/2022

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