• Revenue Cycle Director

    Job Locations US-MO-Chesterfield
    Job ID
    # of Openings
    Hidden (8713)
  • Overview


    Patient Minded I act with the patient’s best interest in mind.

    Client Delight I own every client experience and its impact on results.

    Take Action I am empowered and empower others to act now.

    Grow Talent I own my development and invest in the development of others. 

    Win Together I passionately connect with anyone, anywhere, anytime to achieve results.

    Communication Matters I speak up to create transparent, thoughtful and timely dialogue.

    Own It I hold myself and others accountable for results.



    The Director, Revenue Cycle is responsible for all billing and collection activities associated with payer and patient accounts. They lead, coach and manage staff responsible for billing and collection activities as it relates to revenue for each Patient Services client.  A vital aspect of this role is to achieve maximum reimbursement by ensuring the accurate and timely submittal of claims and to ensure that the claims are paid according to our contracted rates. The Director, Revenue Cycle is also responsible for establishing and exceeding the metrics for each program under his/her responsibility. This position is highly visible and requires a strong leader with the ability to prioritize, plan, and direct the department. The Director, Revenue Cycle will work with the Payer Specialist and Finance teams in a collaborative and productive manner to support ongoing client business. They are also responsible for presenting key Billing and Collection metrics to clients at client meetings, QBR’s and internal meetings where appropriate. 



    Our people leaders are tasked with delivering excellent business results through the efforts of their teams.  These results are achieved by:


    • Setting clear direction, effective plans and measurable outcomes
    • Ensuring work is accomplished effectively by managing employee performance, work processes and other resources
    • Engaging employees to maximize their discretionary effort
    • Developing a pipeline of excellent talent to fill future business needs


    People leaders must possess both the skills to effectively accomplish these tasks and the emotional intelligence to do so in alignment with our cultural values.  In addition to the critical management and leadership tasks listed above, this role also includes the following unique responsibilities:


    • Overall knowledge of the healthcare market to include relevant trends specific to health plans, wholesale/direct bill agreements and Workers Compensation agreements
    • Effective coordination and management of the day to day functions of the Billing and Collections teams to ensure timely and accurate billing and collections for our clients
    • Establish and maintain productive relationships with key contacts within the health plans, contracted institutions and Workers Compensation Insurance companies
    • Establish and maintain productive relationships with key contacts at client representatives


    Essential Duties and Responsibilites:

    • Manage a team of professional individuals dedicated to accurate and timely billing of medical claims and collections of open Accounts Receivable
    • Team management, development and professional progress
      • Guide, coach and manage the Billing and Collection teams
      • Provide transparent and consistent communication to staff
      • Continually evaluate staff in order to achieve maximum productivity
      • Monitor policies related to personnel actions, training and professional development programs
      • Conduct hiring, training and evaluation of staff
    • Responsible for maintaining relationships with the appropriate individuals within each client including bi-weekly communication, QBR’s and all scheduled updates. Communication should be scheduled and proactive
    • Partner with the VP, Client Finance and Accounting to shape the billing and collection strategy and to lead the planning and development of team operational policies as needed
    • Establish workflow, work methods and performance standards for the Billing and Collection teams
    • Drive operational excellence by implementing process improvements for the Billing and Collection teams, specifically in the area of claim appeals, claims processing and denial management
    • Oversee all phases of the billing and collections process across all segments to ensure maximum reimbursement is achieved and in alignment with established objectives
    • Serve as a point of escalation to assist the Billing and Collections teams to resolve complex issues
    • Maintain a strong knowledge of medical billing, CPT/ICD-10 codes, insurance adjudication/processing practices and Medicare/Medicaid rules and regulations
    • Work in conjunction with the VP, Client Finance and Accounting and other executive leaders to ensure teams are aligned to meet program needs and goals
    • Partner with the accounting team to resolve internal or client questions specific to collections, denials and audits
    • Minimal travel required (less than 10%)




    The above list reflects the general details necessary to describe the principle and essential functions of the position and shall not be construed as the only duties that may be assigned for the position.


    An individual in this position must be able to successfully perform the essential duties and responsibilities listed above. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.


    MINIMUM qualifications:

    The requirements listed below are representative of the experience, education, knowledge, skill and/or abilities required.

    • Bachelor’s degree in accounting, business, or related field
    • 7 years of experience in finance
    • Previous management experience required
    • Ability to look at a problem from several perspectives and recommend solutions and courses of action
    • Excellent communication (written, verbal, and presentation) skills with ability to interact with all levels of the organization and represent the organization when interacting with clients
    • A track record of utilizing tact, diplomacy, judgment and negotiation skills to achieve mutually beneficial goals for an organization
    • Embraces conflict in a positive manner and demonstrates the ability to resolve issues in a timely manner
    • Highly developed time management skills with demonstrated ability to meet deadlines, follow-through, and handle multiple priorities with a high degree of initiative require
    • Commitment to process improvement techniques, along with the ability to work with the appropriate individuals within the organization to execute effectively
    • Demonstrates ability to manage, mentor, train and develop employees
    • Demonstrates a capacity and desire for continual learning
    • Experience with and extensive knowledge of Government and Commercial health plans
    • Experience with Pharmacy Management Benefit (PBM) plans


    Preferred qualifications:

    • Master’s degree in business or equivalent
    • 5 years of experience with Emdeon and/or Zirmed billing systems
    • 5 years of experience with pharmacy operating system



    This is a largely sedentary role.  While performing the duties of this job, the employee is regularly required to talk, hear, type and engage in repetitive motion. 


    The employee frequently is required to walk; use hands to finger, handle or feel; and reach with hands and arms.  The employee is occasionally required to stand or grasp. The employee is intermittently required to stoop or crouch; push or pull; or kneel. 


    The employee must occasionally lift and/or move up to 10 pounds and intermittently lift and/or move up to 25 pounds.  Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.


    This role requires mental alertness. The employee must regularly communicate both verbally and written; concentrate on tasks; remember and observe details; problem solve, supervise, and make decisions. The employee must frequently adjust to changes; handle stress and emotions; and think analytically.


    The mental and physical requirements described here are representative of those that must be met by an individual to successfully perform the essential functions of this position.


    Working ENVIRONMENT:

    This job operates in a professional office environment. This role routinely uses standard office equipment. The noise level in the work environment is usually moderate.  The employee is not substantially exposed to environmental conditions.


    The work environment characteristics described here are representative of those an individual encounters while performing the essential functions of this position.





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