The Director of RCM (Medical Billing and Collections) is the lead member of a team whose primary responsibility is the processing of insurance and other third-party payer claims. The Director collaborates with the Chief Operations Officer to ensure timely and accurate submission of patient remittance claims and management of accounts receivable. The Director of RCM supervises all billing, collections, and receivable staff. Experience in coding Orthopedic Surgery, Podiatry, Physical Therapy, and Radiology is a plus.
Work with a fast-growing company that has implemented the latest technology for charge entry and coding. Synergy Orthopedic Specialists is the largest independent medical group in San Diego. The coding and Charge Management department is responsible for submitting all charges related to the services rendered by Orthopedic, Physical Therapy, and Radiology providers.
Synergy Orthopedic Specialists Medical Group is one of the largest, most comprehensive medical groups in San Diego County, and is recognized for excellence in patient satisfaction and clinical care. For patient convenience and improved coordination of care, Synergy Orthopedic Specialists offers integrated care and services like orthopedics, radiology, physical therapy, and podiatry in San Diego.
Synergy Orthopedic Specialists is proud to be an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, disability, gender identity, transgender status, sexual orientation, protected veteran status, or any other protected class.
Essential Functions
- Responsible for oversight of patient collections and financial counseling, insurance authorization, cash applications, and credit balance teams. Lead day-to-day operations and broadly scoped work assignments focused on maximizing quality and production processes.
- Develops new approaches to streamline existing processes, reorganizes work, and improves resource utilization for cash applications, insurance verification, and patient collections teams.
- Develop reports to track key performance indicators and monitor and manage overall patient collection performance.
- Monitors and identifies processes to be implemented in order to achieve key revenue cycle metrics including but not limited to cash collections, unbilled A/R, aging over 90 days, and Days in AR.
- Performs ongoing trend analysis on patient payment levels and denial rates to ensure that reimbursement is in accordance with allowable amounts stated in agreements and contracts. Minimizes contractual and bad debt write-offs. Works collaboratively with outside collection agencies to ensure maximum collection efforts.
- Closely monitors denial trends and research root cause issues while developing solutions to improve overall denial metrics. Collaborates with internal customers to mitigate denial creation.
- Analyzes month-end reports to identify opportunities for process improvements with respect to claims denials and outstanding patient A/R.
- Oversees the management team to ensure that productivity and accuracy audits are being performed, department policies are followed and administered fairly. Ensures that all staff is being held accountable for performance.
- Ensures that all payment posting is accurately posted and that effective balancing processes are in place and consistently followed.
- Responsible for ensuring credit balance thresholds are met and processes are followed according to internal policies.
- Resolve complex payer or physician issues when necessary. Act as a primary point of escalation contact for clinical operations for day to day operational issues relating to billing, collections, and denials.
- Maintains comprehensive knowledge of payer billing requirements and reimbursement policies.
- Communicates performance data and action plans to leadership.
- Monitor, assess, and measure the financial impact on the organization of prospective regulatory changes to Federal and State reimbursements.
- Identify opportunities to maximize reimbursement.
- Performs other duties as assigned.
Competencies
- Ethical Conduct
- Problem Solving
- Strategic
- Analytical
- Computer Proficiency
- Demonstrates excellent interpersonal skills with the ability to interface with patients, physicians, and coworkers in a tactful, informed, and service?oriented manner.
- Detailed oriented
COVID-19 precautions
- Personal protective equipment provided or required
- Plastic shield at work stations
- Temperature screenings
- Social distancing guidelines in place
- Virtual meetings
- Sanitizing, disinfecting, or cleaning procedures in place
Job Type: Full-time
Pay: $90,000.00 - $130,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Supplemental Pay:
Education:
Experience:
- health Care: 5 years (Required)
- Finance: 3 years (Required)
- Management: 5 years (Required)
- Director of Revenue Cycle: 3 years (Required)