The RCM Associate Director is responsible operational management of the back end processes of the RCM business whether it be collections, billing and payment posting.This role is responsible for facilitating daily operations functions, including coordination with other departments internal and external affecting back end processes. The position is responsible for driving client SLAs and outcome resolution.
The RCM Associate Director carries out his/her duties by adhering to the highest standards of ethical and moral conduct, acts in the best interest of organization and carries out the Vision and Mission of the organization
Responsibilities
- Oversees Billing or Collection functions, ensuring standardization and compliance with established policies and procedures.
- Provides leadership to and is accountable for the performance and direction through multiple layers of management and senior level professional staff.
- Manage all KPIs and client in collaboration with other onshore and offshore leaders and managers and aspects of change management as it relates to operational processes, driving process metrics, staffing and employee relations.
- Provides operational direction to assigned site, function or COE.
- Drive efficiency and meet/exceed the initiative targets, create strategies to build and sustain operational excellence, identify and work on opportunities to bring in additional scope of work.
- Collaborate in driving and implementing strategies to effectively manage inventory and collect outstanding balances from payers.
- Manage teams for optimum reduction of AR Days, aging, denials write offs and improve cash collection rate.
- Identify issues and trends in AR and collaborate with onshore partners to provide insights to clients and hospital CFOs. Coordinate and escalate issues observed to senior leadership or internal partners like Payor Solutions, Denials Management, Facility Liaisons and other processes within RCM.
- Review adjustment requests and approve those which are valid for write-off
- Client Relationship Management
- Collaborate with Learning Performance Solutions responsible for process design and development, process monitoring, policy and procedure development and training requirements.
- Develop and execute strategies for Billing or Collections.
- Develop policies, procedure and guidelines for operations and review/approve policy and process changes.
- Responsible for creating an environment to identify and groom talent/future leaders within the team, work with cross-functional and direct reports to develop IDPs.
- Champions compliance with security standards and regulations.
- Leads quality improvement processes. Evaluate existing process and recommends process improvements and automation opportunities.
- Initiates and implements strategies to embed quality practices in culture.
Qualifications
- Work Experience:
- 5+ years of experience in Hospital Revenue Cycle or must undergo process training and pass ramp certification
- 12+ years of management/leadership experience.
- Thorough understanding of insurance policies and procedures
- Intermediate to advanced computer skills, must understand Excel
- Excellent written and verbal communication
- Education
- Bachelor's degree in business or related field
- Technical Knowledge
- Excellent analytical and quantitative skills; ability to develop appropriate methods for collecting analyzing and trending data.
- Excellent organizational skills required (ability to multi-task, produce rapid turnaround, and effectively manage multiple projects).
- High sense of responsibility and accountability; Takes ownership and initiative.
- Results-oriented with an eye toward the end-goal and business results as the objective of our projects.
- Ability to think and act; decisiveness, assertiveness, with ability to achieve results quickly.
- Excellent communication capability; persuasive, inclusive, and encouraging; the ability to listen and understand; Ability to elicit cooperation from a variety of resources.
- Adaptable and flexible, with the ability to handle ambiguity and sometimes changing priorities.
- Professional demeanor and positive attitude; customer service orientation.
- Ability to learn, understand, and apply new technologies, methods, and processes.
- Ability to recognize necessary changes in priority of tasks and allocation of resources, and bring them to the attention of the Leadership Team, as required.
- Ability to be a self-starter and work independently to move projects successfully forward.
- Ability to work with a variety of individuals in managerial and staff level positions.
- Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of the organization and our client organization(s).
