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Altus Community Healthcare · 5 months ago

Associate Director of Revenue Cycle (Billing and Coding)

Houston, TX

Full-time

Onsite

Senior Level

Altus Community Healthcare is seeking an Associate Director of Revenue Cycle – Billing and Coding to oversee and manage all aspects of coding and front-end billing workflows. The role involves strategic planning, team management, compliance, and collaboration with internal departments to improve operational efficiency and enhance patient collection processes.

Health CareHospital

Responsibilities

Ensure timely and efficient medical claims billing with monitoring of medical coding, clearing house and front-end billing workflows and processes

Strategic planning: Develop and implement strategic plans, objectives, and initiatives for revenue cycle collections to align with the organization’s goals and objectives

Team Management: Direct oversight, training, and monitoring of internal and external coding and billing teams with oversight of all operations, workflows, processes, and training. Coordinate and aid in the training of billing team members to collaborate and ensure goals and initiatives are sustained on identified metrics

Billing: Coordinate leadership and guidance with Patient Collection and Registration Team to ensure proper documentation and collection of patient demographics for correct billing and improved clean claim billed rates. Make recommendations for workflow and process improvements as needed

Front-end Denials Management: Ensure all clearing house denials are properly reviewed to ensure correct and timely processing of insurance claims. Track trends and identify areas of improvement and efficiency to aid in overall reduction of initially denied claims

EDI Management: Complete oversight and tracking of Payer portals, clearinghouse, ERA and EFT access and enrollments to streamline and improve efficiency in claims billing and payment posting. Make recommendations for process improvement and training as needed

Compliance: Ensure compliance with all healthcare state and federal regulations, privacy laws and billing requirements. Maintain accurate and up-to-date knowledge of industry regulations and best practices

Oversight of Payment Posting team to ensure all defined metrics and goals are obtained and sustained. Make recommendations for process improvement and training as needed

Technology and Systems: Evaluate, select, and implement claims billing systems and technologies to support efficient registration, scheduling, and data management processes

Collaboration: Foster effective communication and collaboration with other internal departments to optimize patient flow, coordination of care and billing of medical claims

Performance Metrics: Develop and monitor key performance indicators (KPIs) to assess the effectiveness and efficiency of collection services and team members and implement strategies to achieve performance targets

Auditing: Perform and/or oversight of daily, weekly, and monthly audits on coding and billing team members and processes to ensure production and quality assurance goals and standards are achieved and maintained. Address any variances with work plan or personal improvement plans

Reporting: Prepare and present weekly and monthly department reports as needed

Participate in performance improvement activities as necessary

Perform other duties as assigned

Qualification

Revenue cycle managementCoding expertiseDenials managementLeadership skillsHealthcare regulations knowledgeData analysisProcess improvementPatient access softwareCommunication skillsInterpersonal skills

Required

Bachelor's degree in healthcare administration, business administration, or a related field

Extensive experience in coding, front end billing, denials management, payment posting, ERA, EFT and website enrollment; preferable in a free-standing emergency room facility setting

In-depth knowledge of healthcare regulations, privacy laws, and billing requirements

Strong leadership and team management skills

Excellent communication and interpersonal skills

Ability to analyze data, identify trends, and make data-driven decisions

Proficient in using healthcare information systems and patient access software

Knowledge of revenue cycle management processes and strategies

Proven track record in process improvement and implementing best practices

Preferred

Master's degree

Company

Altus Community Healthcare

Located in Houston, Texas, Altus Community Healthcare's mission is to serve our neighborhood and surrounding areas with the highest standards of medical care and compassion.

Founded in 2003