Director of Revenue Cycle

Director of Revenue Cycle - Houston, TX

Job Duties:

Manages the department within the established budget.

Manages the precertification process between the physician practice and the hospital/ASC and tracks statistical information monthly.

Manages the coding process implemented to assure the most accurate and cost effective coding of all claims.

Manages the filing and resolution of claims with individual carriers or agencies.

Insures

maximum reimbursement through strategic financial planning.

Monitors changes in the medical insurance industry and adjusts procedures accordingly. Aggressively pursues cost reimbursement through settlement negotiations.

Reviews and evaluates health insurance claim policies and procedures for insurance

plans, develops

new procedures to improve the quality and quantity of work processed.

Monitors and evaluates monthly insurance reimbursements compliance and budgets.

Manages

updating

of contract matrix with accurate terms and fee schedules and establishes a common reimbursement grid by procedure code.

Manages the collection of accounts, the maintenance of the Medicare bad debt and the outsourcing of account receivables following appropriate protocols.

Solves difficult insurance claim problems.

Supervises, trains, and mentors assigned personnel. Evaluates performance and recommends merit increases, promotions

and

disciplinary actions.

Initiates and answers pertinent correspondence. Prepares and writes reports. Maintains required records and files.

Maintains knowledge of and complies with established policies and procedures.

Education:

Bachelor’s degree in business or equivalent. Master’s degree preferred.

Experience:

Minimum five years supervisory experience in a health care setting.

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