director of reimbursement

UF Health Shands Hospital

<div>Overview:
<p>
Develops and executes strategies to optimize revenue while ensuring compliance with regulatory requirements. Leads negotiations with payers and government agencies to secure favorable reimbursement rates and contract terms. Oversees analysis of reimbursement trends and policies, collaborating with cross-functional teams to align initiatives with business goals. Manages reimbursement documentation, appeals, and monitors payer performance to minimize denials and delays. Advises senior leadership on reimbursement risks and opportunities is a key aspect of this position to support informed strategic decision-making.</p>
Responsibilities:
<p><b>
Key Responsibilities</b></p><ul><li>Develops and executes strategies to optimize revenue.</li><li>Ensures compliance with regulatory requirements.</li><li>Leads negotiations with payers and government agencies.</li><li>Secures favorable reimbursement rates and contract terms.</li><li>Oversees analysis of reimbursement trends and policies.</li><li>Collaborates with cross-functional teams to align initiatives with business goals.</li><li>Manages reimbursement documentation, appeals, and monitors payer performance.</li><li>Advises senior leadership on reimbursement risks and opportunities.&quot;</li></ul>
Qualifications:
<p><b>
Qualifications</b></p><ul><li>8+ years of healthcare reimbursement leadership experience</li><li>Expertise in payer negotiations and revenue cycle management</li><li>Strong analytical and strategic planning skills</li><li>Experience managing reimbursement teams and processes</li><li>Proficient in reimbursement and billing software&quot;</li></ul></div>

Director of Reimbursement

Aeroflow Health

<p>Aeroflow Health &ndash; Mom and Baby Director of Reimbursement Research &amp; Coding Strategy<br/></p><p>Location - Remote with some travel to Asheville NC - Roughly once a month for 3-4 days.<br/></p><p>Aeroflow Health is a leading provider of home medical equipment and clinical support services, helping patients across the country access the products and care they need to live healthier lives at home. Through innovative technology, streamlined delivery platforms, and deep expertise in insurance navigation, we remove barriers to care and simplify complex healthcare processes for families, providers, and payers alike.<br/></p><p>We are equally as passionate about taking care of our employees. Recognized as one of the fastest-growing healthcare companies in the U.S., an Inc. 5000 honoree, and a certified Great Place to Work&reg;, Aeroflow continues to seek ways they can be one of the nation&rsquo;s top employers. As we continue to grow, we remain committed to building an exceptional workplace where talented professionals are empowered, supported, and inspired to make meaningful impact every day.<br/></p><p>The Opportunity<br/></p><p>Aeroflow Health is seeking a Director of Reimbursement Research &amp; Coding Strategy to serve as the enterprise&rsquo;s subject-matter expert in medical billing, coding, payer policy, and reimbursement strategy across maternal health, telehealth, and evolving clinical service lines.<br/></p><p>This role is not operational billing management&mdash;rather, it is the strategic engine ensuring Aeroflow codes, documents, bills, and delivers clinical services in a way that is:<br/></p><p>Compliant with federal and state regulations<br/>Aligned to payer-specific rules and provider requirements<br/>Optimized for accurate reimbursement and financial sustainability<br/>Scalable as Aeroflow expands into new services and provider types<br/></p><p>This leader will partner closely with payer relations, clinical leaders, compliance, and business unit operators to research, interpret, and translate payer rules into actionable billing and coding guidance.<br/></p><p>Examples of supported areas include:<br/></p><p>Lactation classes and clinical lactation services<br/>CHW care coordination programs<br/>Nutrition &amp; perinatal education programs<br/>Doula and birth support services<br/>Telehealth medical visits and remote patient monitoring<br/>New clinical services added across Aeroflow business units<br/></p><p>Your Primary Responsibilities<br/></p><p>We are currently seeking a Director of Reimbursement Research &amp; Coding Strategy to:<br/></p><p>Serve as Aeroflow&rsquo;s enterprise expert on federal, state, and commercial reimbursement rules across telehealth, maternal health, DME-adjacent services, and emerging care models.<br/>Research and interpret coverage policies, billing rules, provider qualifications, supervision requirements, and documentation standards.<br/>Evaluate new service offerings for reimbursement viability, including coding pathways, provider credentialing needs, and payer-specific limitations.<br/>Maintain deep knowledge of CPT, HCPCS, ICD-10, and emerging codes relevant to maternal, perinatal, and education services.<br/>Develop and maintain a centralized coding strategy for classes, clinical services, virtual care, and hybrid product + service models.<br/>Ensure Aeroflow uses the correct codes, billing modifiers, place-of-service designations, and documentation requirements for each service type.<br/>Identify gaps or inconsistencies in billing and coding and recommend corrections.<br/>Assess provider types required for billable services (e.g., IBCLC, MD, NP, PA, PT, CHW, doula) and ensure alignment to payer rules.<br/>Work closely with the Payer Relations team to align internal billing methodology with contract terms and coverage decisions.<br/>Collaborate with clinical leaders to ensure documentation templates support compliant billing.<br/>Advise Product &amp; Technology teams on documentation capture, coding logic, and workflow automation opportunities.<br/>Partner with Compliance to prepare for audits and ensure regulatory adherence.<br/>Build playbooks, coverage matrices, SOPs, and educational materials that translate payer rules into clear operational guidance.<br/>Serve as the escalation point for coding questions, new benefit review, and payer interpretation issues.<br/>Employee has an individual responsibility for knowledge of and compliance with laws, regulations, and policies.<br/>Compliance is a condition of employment and is considered an element of job performance<br/>Maintain HIPAA/patient confidentiality<br/>Regular and reliable attendance as assigned by your schedule<br/>Other job duties assigned<br/></p><p>Skills for Success<br/></p><p>Regulatory &amp; Policy Expert: Deep understanding of how payer rules, state Medicaid programs, and CMS guidelines drive billing strategy.<br/>Analytical Researcher: Ability to break down complex reimbursement policies into actionable guidance.<br/>Healthcare Coding Strategist: Strong command of telehealth, maternal health, PT/OT, CHW, and education-service coding frameworks.<br/>Cross-Functional Influencer: Able to guide diverse teams (clinical, payer relations, compliance, product) toward aligned solutions.<br/>Operational Translator: Skilled at converting regulatory language into practical processes and documentation standards.<br/>Adaptive Leader: Thrives in a high-growth environment with evolving services and state-by-state policy nuances.<br/></p><p>Required Qualifications<br/></p><p>8+ years of experience in medical reimbursement, payer policy analysis, provider coding, or regulatory research.<br/>Demonstrated expertise in CPT/HCPCS/ICD-10 coding and payer policy interpretation.<br/>Experience with telehealth, maternal health services, or multi-state reimbursement environments.<br/>Strong understanding of Medicare, Medicaid, and commercial coverage policies.<br/>Experience evaluating reimbursement feasibility for new clinical or educational services.<br/>Advanced skills synthesizing policy, coding, and compliance into recommendations for senior leadership.<br/></p><p>You might also have<br/></p><p>Coding certifications such as CPC, CPB, CCS, CRC, or similar.<br/>Experience with perinatal or women's health services (e.g., lactation, doula, CHW, PT).<br/>Familiarity with payer negotiations or working alongside payer relations teams.<br/>Experience with virtual care delivery and hybrid clinical + product models.<br/>Background supporting multi-service, multi-state healthcare organizations.<br/>Working knowledge of documentation workflows, EHR systems, and billing logic automation.<br/></p><p>What Aeroflow Offers<br/></p><p>Competitive Pay, Health Plans with FSA or HSA options, Dental, and Vision Insurance, Optional Life Insurance, 401K with Company Match, 12 weeks of parental leave for birthing parent/ 4 weeks leave for non-birthing parent(s), Additional Parental benefits to include fertility stipends, free diapers, breast pump, Paid Holidays, PTO Accrual from day one, Employee Assistance Programs and SO MUCH MORE!!<br/></p><p>Here at Aeroflow, we are proud of our commitment to all of our employees. Aeroflow Health has been recognized both locally and nationally for the following achievements:<br/></p><p>Family Forward Certified<br/>Great Place to Work Certified<br/>Inc. 5000 Best Place to Work award winner<br/>HME Excellence Award<br/>Sky High Growth Award<br/></p><p>If you&rsquo;ve been looking for an opportunity that will allow you to make an impact, and an organization with unlimited growth potential, we want to hear from you!<br/></p><p>Aeroflow Health is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.<br/></p><p>We value transparency and candidate safety throughout the hiring process. Aeroflow recruiters may reach out through platforms such as LinkedIn or Indeed; however, all interviews and/or offer coordination and sensitive information requests will occur only through our official communication channels. You will never be asked to provide personal data outside our secure application portal, and all interview or offer details will come from an @aeroflowinc.com email address. We do not conduct interviews via text message or instant-messaging apps. If you have concerns, please contact our Talent Acquisition team for verification<br/></p>

Director of Reimbursement Research & Coding Strategy- Mom & Baby

HeartShare

<div><div><div>The Director of Billing at HeartShare Human Services is responsible for leading and optimizing all aspects of predominantly Medicaid billing and overall revenue cycle performance across the organization, ensuring timely and accurate claim submission, maximizing reimbursement, and maintaining compliance with all federal and state Medicaid regulations. This role oversees a data-driven billing operation, leveraging analytics, key performance indicators (KPIs), and system reporting to monitor productivity, denial trends, reimbursement rates, and accounts receivable performance, while driving continuous improvement through the use of technology, including the Millin billing platform, and implementation of best practices that enhance efficiency, accuracy, and financial outcomes. The Director partners closely with Fiscal, Program Operations, and Compliance teams to ensure billing integrity, strengthen internal controls, and support strategic decision-making related to revenue generation and regulatory compliance.</div></div><p><b>
Primary Responsibilities and Essential Functions of Position:
</b></p><div><div><b>Revenue Cycle Oversight</b></div></div><ul><li><div>
Lead and manage the full Medicaid revenue cycle, including claim submission, rebilling, payment posting, denial management, and accounts receivable reconciliation.</div></li><li><div>
Ensure timely claim submission and reimbursement optimization across all Medicaid-funded programs and other non-Medicaid programs (e.g., private pay, ISS).</div></li><li><div>
Monitor aging accounts receivable and implement strategies to maintain optimal collection timelines.</div></li></ul><div><div><b>
Data Analytics and KPI Management</b></div></div><ul><li><div>
Develop and monitor KPIs for billing operations, including:</div></li><li><div>
Clean claim rate</div></li><li><div>
Days in accounts receivable</div></li><li><div>
Denial rates and root cause trends</div></li><li><div>
Claims submission timeliness</div></li><li><div>
Reimbursement cycle times</div></li><li><div>
Billing productivity metrics</div></li><li><div>
Utilize the Millin system reporting and data analytics tools to analyze billing performance and identify opportunities for revenue improvement.</div></li><li><div>
Produce regular billing analytics reports and dashboards for Fiscal leadership, highlighting operational trends, revenue performance, and risk areas.</div></li></ul><div><div><b>
Team Leadership and Operational Management</b></div></div><ul><li><div>
Lead, mentor, and supervise the billing team to ensure high performance, accuracy, and accountability.</div></li><li><div>
Establish performance expectations and productivity metrics for billing staff.</div></li><li><div>
Support professional development and cross-training to strengthen team capacity and operational resilience.</div></li></ul><div><div><b>
Compliance and Regulatory Oversight</b></div></div><ul><li><div>
Ensure compliance with all Medicaid regulations, billing policies, and payer requirements.</div></li><li><div>
Oversee internal billing audits and coordinate preparation for external Medicaid or regulatory audits.</div></li><li><div>
Maintain up-to-date knowledge of Medicaid regulatory changes and reimbursement guidelines.</div></li></ul><div><div><b>
Process Improvement and Systems Optimization</b></div></div><ul><li><div>
Evaluate billing workflows and implement process improvements to reduce errors, increase automation, and improve reimbursement turnaround.</div></li><li><div>
Collaborate with IT and Fiscal to optimize use of the Millin billing system, including reporting functionality and workflow configuration.</div></li><li><div>
Identify opportunities for system enhancements, data integrity improvements, and operational efficiencies.</div></li></ul><div><div><b>
Cross-Functional Collaboration</b></div></div><ul><li><div>
Partner with program leadership, clinical teams, and fiscal staff to resolve billing issues and strengthen documentation processes that support compliant billing.</div></li><li><div>
Serve as the primary liaison with Medicaid representatives and external partners related to billing and reimbursement matters.</div></li></ul><ul><li><div><div>
Bachelor&rsquo;s degree in Accounting, Finance, Healthcare Administration, or a related field <b>required</b>.</div></div></li><li><div><div>
Minimum 7&ndash;10 years of healthcare or human services billing experience, including at least 3&ndash;5 years in a leadership position overseeing Medicaid billing operations.</div></div></li><li><div><div>
Demonstrated experience managing billing operations using Millin or comparable Medicaid billing and revenue cycle platforms.</div></div></li><li><div><div>
Advanced Excel skills experience required (e.g., VLookup, Pivot Table).</div></div></li><li><div><div>
Strong experience developing and monitoring billing key performance indicators (KPIs), operational dashboards, and performance metrics.</div></div></li><li><div><div>
Advanced knowledge of Medicaid billing regulations, claim submission protocols, rate structures, and payer requirements.</div></div></li><li><div><div>
Proven ability to analyze billing data to identify revenue unaccounted loss of income due to underbilling, unbilled, errors, denial trends, and process improvement opportunities.</div></div></li><li><div><div>
Strong analytical, leadership, and communication skills with the ability to translate complex billing data into actionable insights.</div></div></li><li><div><div>
Experience implementing workflow improvements and automation within billing or revenue cycle processes.</div></div></li><li><div><div>
Experience managing billing operations in a human services, behavioral health, or nonprofit environment preferred.</div></div></li><li><div><div>
Demonstrated ability to train, mentor, and develop billing staff while promoting accountability and performance management.</div></div></li><li><div><div>
Familiarity with Medicaid audits, regulatory reporting, and compliance oversight.</div></div></li></ul><p>
</p><div><div><b>Benefits</b></div></div><div><div>
At HeartShare we offer a comprehensive benefit package based on full-time/part-time status. You can expect:</div></div><ul><li><div>
Rewarding Work in a team environment.</div></li><li><div>
Paid vacation, sick, personal days, and holidays.</div></li><li><div>
403(B) retirement plans with employer contribution.</div></li><li><div>
Health, dental, vision and life insurance.</div></li><li><div>
Employee Assistance Program (EAP).</div></li><li><div>
Flexible spending account (Dependent Care, Medical, Parking, and Transit).</div></li><li><div>
Employee Appreciation Programs and Events.</div></li><li><div>
Tuition Assistance Program.</div></li><li><div>
Professional Development opportunities.</div></li><li><div>
Wellhub Discount</div></li><li><div>
Verizon Wireless Discount.</div></li><li><div>
BJs Membership discount.</div></li><li><div>
Discounts on Broadway tickets, movie tickets, theme parks, sporting events, gift certificates &amp; more</div></li></ul><div><div>
HeartShare is an Equal Opportunity Employer (EOE). If you need to request accommodation during the recruiting process, please reach out to Leaves@heartshare.org.
</div></div><p></p><div><div><b>About Heartshare</b></div></div><div><div>
Who WE ARE:</div></div><div><div>
For over 150 years, Heartshare has been dedicated to championing and empowering New Yorkers society has too often overlooked and underestimated.</div></div><p>
</p><div><div>To learn more about HeartShare, please visit our website at www.heartshare.org or Follow us on Twitter LinkedIn YouTube Instagram Facebook</div></div><div><div>
HeartShare Human Services of New York | Homepage</div></div><div><div>
HeartShare Human Services of New York nurtures and empowers children and adults with intellectual and developmental disabilities.</div></div></div>

Director of Billing

Family Centers

<div><p>Onsite</p><p>
Full Time, 35 hours</p><p>
Greenwich, CT</p><p></p><p><b><br>
Overview</b></p><p>
The Director of Revenue Cycle provides strategic and operational leadership for all revenue cycle functions at Family Centers. This role oversees billing, coding, collections, payer enrollment, and denial management to ensure financial sustainability and compliance with applicable regulations, including HRSA and Federally Qualified Health Center (FQHC).</p><p>
Working closely with the Chief Financial Officer and organizational leadership, the Director of Revenue Cycle leads initiatives to improve revenue integrity, optimize reimbursement, strengthen internal controls, and enhance the overall efficiency of revenue cycle operations across Family Centers&rsquo; multi-site clinics.</p><p><b>
The Role</b></p><ul><li>
Lead and implement revenue cycle strategies that support the organization&rsquo;s financial goals and long-term sustainability.</li><li>
Oversee all revenue cycle operations including charge capture, coding, billing, collections, payer enrollment, credentialing oversight, and denial management.</li><li>
Monitor KPIs such as days in accounts receivable, payer reimbursement trends, and denial rates, and implement improvement strategies.</li><li>
Ensure compliance with FQHC regulations, HRSA requirements, and sliding fee scale policies.</li><li>
Review payer contracts to ensure reimbursements align with negotiated rates and identify opportunities for improvement.</li><li>
Maintain strong internal controls related to revenue management and safeguarding of financial assets.</li><li>
Collaborate with leadership to improve workflows, resolve operational issues, and increase overall efficiencies.</li><li>
Recruit, train, and manage revenue cycle staff while promoting accountability, professional development, and cross-training.</li><li>
Oversee departmental policies, procedures, and performance standards to ensure consistency and compliance.</li><li>
Utilize electronic health record and billing systems to monitor performance, analyze trends, and identify improvement opportunities.</li><li>
Prepare and present revenue cycle performance reports and financial metrics to senior leadership.</li><li>
Other duties as assigned</li></ul><p><b>
Requirements</b></p><ul><li>
Bachelor&rsquo;s degree plus at least 10 years of healthcare revenue cycle experience, encompassing leadership responsibility.</li><li>
Demonstrated knowledge of healthcare billing practices, payer reimbursement processes, and revenue cycle operations.</li><li>
Understanding of Medicare, Medicaid, CPT, CDT, and ICD-10 coding standards.</li><li>
Experience managing teams and driving performance improvement.</li><li>
Proficiency with Microsoft Office and healthcare billing systems.</li></ul><p><b>
Preferred</b></p><ul><li>
At least 5 years of experience working in a Federally Qualified Health Center (FQHC) or community health center setting.</li><li>
Professional certification such as CRCR, HFMA, or similar.</li><li>
Experience with Epic or comparable electronic health record systems.</li><li>
Demonstrated success improving revenue cycle performance and operational efficiency.</li></ul><p><b>
About Family Centers</b></p><p>
Family Centers is a private, nonprofit organization providing health, education, and human services to children, adults, and families throughout Fairfield County. Our team of more than 300 professionals and over 500 trained volunteers collaborate to deliver a wide range of responsive and innovative programs. Through our comprehensive network of services, more than 26,000 children, adults, families, and communities each year receive the care, encouragement, and resources they need to realize their potential.</p><p><b>
Benefits &amp; Perks</b></p><p>
At Family Centers, we believe in taking care of our compassionate staff who care for our community. We offer a comprehensive benefits package designed to support employee health, financial wellbeing, and work-life balance.</p><p>
Full-time employees enjoy:</p><ul><li>
Generous Paid Time Off &ndash; Up to 15 vacation days annually (increases to 25 days after 10 years), 11 paid holidays, up to 3 personal days, and up to 10 sick days</li><li>
Half-Day Summer Fridays (in select programs)</li><li>
Medical, Dental &amp; Vision Coverage Options</li><li>
Health Savings Account (HSA) with monthly employer contributions</li><li>
Flexible Spending Accounts (FSA &amp; DCA)</li><li>
403(b) Retirement Plan with up to 6% employer contribution</li><li>
Employer-Paid Long-Term Disability, Life &amp; AD&amp;D Insurance</li><li>
Employee Assistance Program (EAP)</li><li>
Voluntary benefits including Critical Illness Insurance, Pet Insurance, and supplemental Life Insurance</li><li>
Tuition Assistance (eligible after 6 months of service)</li></ul><p>
Family Centers has been consistently recognized as one of the Top Workplaces in Western Connecticut by Hearst Connecticut Media and holds a perfect 100 Encompass rating from Charity Navigator.</p><p>
For more information and to apply, please visit <b>www.familycenters.org</b> or our LinkedIn page.</p><p>
Family Centers is committed to providing equal employment opportunities to all applicants and employees as indicated in applicable federal and/or state laws.</p></div><p></p>

Director of Revenue Cycle

Tenet Healthcare

<div><h3 class="jobSectionHeader"><b>Job Summary</b></h3>
<p>The <b>National</b> <b>Director Revenue Cycle</b> is responsible for end-to-end management of people, processes and systems supporting Tenet Physician Resources (TPR) patient service revenue. In this role, the Director will provide leadership across all levels of TPR to support the revenue cycle and meet/exceed established goals.
</p><p>The revenue cycle is defined as all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue. The National Director is responsible for enhancing and maintaining a properly functioning revenue cycle process through a cross-department organizational structure. These functional areas act interdependently during a patient visit, contributing critical information required for clinical service and procuring payment. Thus, the National Director concentrates resources on improving core clinical care delivery and protecting the assets of the organization. The position will provide leadership and subject matter expertise related to the development of a compliant, comprehensive revenue cycle across TPR.</p>
<h3 class="jobSectionHeader"><b>
Responsibilities</b></h3>
<ul><li>The National Director will be responsible for improving cash collections, minimize bad debt and work with Operations Directors to ensure timely claims posting; meeting or exceeding all budgeted targets.</li>
<li>Develop a high-performance team as measured through achievement of benchmark process outcomes, audit and compliance results, financial goals and employee satisfaction.
</li><li>Recruit and build leadership and management talent throughout the revenue cycle operation.
</li><li>Ensure transparency on goals and performance improvement throughout the revenue cycle process.</li>
<li>Lead effectively across matrix structures achieving high performance outcomes, as defined above, for staff involved in revenue cycle that report to other areas of the operation, including physicians, managers and staff at point of service charge entry and cash collection.</li>
<li>Provide subject matter expertise in the functional areas of billing, collections &amp; bad debt, payment processing, denial management, accounts receivable finance operations, health information management (HIM), patient financial services, fee schedule development and maintenance, documentation and coding, and charge capture.
</li></ul><h3 class="jobSectionHeader"><b>Qualifications</b></h3>
<p><b>Required:</b></p>
<ul>
<li>Bachelor's degree in Business Administration, Public Health, Health Administration or related field.</li>
<li>8-12 years in consulting, project management, and/or general management experience in provider-based revenue cycle management.</li>
<li>Business expertise, financial acumen and interpersonal skills to effectively work through a complex organization to influence and facilitate sustainable change.</li>
<li>Advanced interpersonal communication skills (written and verbal) to deal effectively in delicate, sensitive and/or complex situations with a wide variety of influential internal and external parties.</li>
<li>Strong leader with a collaborative nature who can develop solutions, with multiple and geographically dispersed stakeholders, to complex process and organizational issues.</li>
<li>Up to 10% national travel. We will run a MVR on the final candidate.</li>
</ul>
<p><b>Preferred:</b></p>
<ul>
<li>Master's degree in Business Administration, Public Health, Health Administration or related field.</li>
<li>Previous experience as a Revenue Cycle Director.</li>
<li>Healthcare operations management experience in a health plan, managed care organization, medical group or hospital setting.</li>
<li>Knowledge of or exposure to Athena Health (and specifically its billing, collection and EHR subsystems).</li>
</ul>
<p><b>Compensation:</b></p>
<ul>
<li>Pay: $150,000 - $200,000 annually. Compensation depends on location, qualifications, and experience.
</li><li>Position may be eligible for an Annual Incentive Plan bonus of 10%-25% depending on role level.
</li><li>Management level positions may be eligible for sign-on and relocation bonuses.</li>
</ul>
<p><b>Benefits:</b></p>
<p>
The following benefits are available, subject to employment status:</p>
<ul>
<li>Medical, dental, vision, disability, life, AD&amp;D and business travel insurance</li>
<li>Manager Time Off &ndash; 20 days per year</li>
<li>Discretionary 401k with up to 6% employer match</li>
<li>10 paid holidays per year</li>
<li>Health savings accounts, healthcare &amp; dependent flexible spending accounts</li>
<li>Employee Assistance program, Employee discount program</li>
<li>Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder &amp; childcare, auto &amp; home insurance.</li>
<li>For Colorado employees, paid leave in accordance with Colorado&rsquo;s Healthy Families and Workplaces Act.</li>
</ul>
<p>#LI-JR1</p>
<p>Employment practices will not be influenced or affected by an applicant&rsquo;s or employee&rsquo;s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.<br>
Tenet participates in the E-Verify program. Follow the link below for additional information.<br>
E-Verify: http://www.uscis.gov/e-verify<br>
The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations.
</p>
2603006136</div>
<br>
<ul><li>The National Director will be responsible for improving cash collections, minimize bad debt and work with Operations Directors to ensure timely claims posting; meeting or exceeding all budgeted targets.</li>
<li>Develop a high-performance team as measured through achievement of benchmark process outcomes, audit and compliance results, financial goals and employee satisfaction.
</li><li>Recruit and build leadership and management talent throughout the revenue cycle operation.
</li><li>Ensure transparency on goals and performance improvement throughout the revenue cycle process.</li>
<li>Lead effectively across matrix structures achieving high performance outcomes, as defined above, for staff involved in revenue cycle that report to other areas of the operation, including physicians, managers and staff at point of service charge entry and cash collection.</li>
<li>Provide subject matter expertise in the functional areas of billing, collections &amp; bad debt, payment processing, denial management, accounts receivable finance operations, health information management (HIM), patient financial services, fee schedule development and maintenance, documentation and coding, and charge capture.</li></ul>
<br>
<div><p><b>Required:</b></p>
<ul>
<li>Bachelor's degree in Business Administration, Public Health, Health Administration or related field.</li>
<li>8-12 years in consulting, project management, and/or general management experience in provider-based revenue cycle management.</li>
<li>Business expertise, financial acumen and interpersonal skills to effectively work through a complex organization to influence and facilitate sustainable change.</li>
<li>Advanced interpersonal communication skills (written and verbal) to deal effectively in delicate, sensitive and/or complex situations with a wide variety of influential internal and external parties.</li>
<li>Strong leader with a collaborative nature who can develop solutions, with multiple and geographically dispersed stakeholders, to complex process and organizational issues.</li>
<li>Up to 10% national travel. We will run a MVR on the final candidate.</li>
</ul>
<p><b>Preferred:</b></p>
<ul>
<li>Master's degree in Business Administration, Public Health, Health Administration or related field.</li>
<li>Previous experience as a Revenue Cycle Director.</li>
<li>Healthcare operations management experience in a health plan, managed care organization, medical group or hospital setting.</li>
<li>Knowledge of or exposure to Athena Health (and specifically its billing, collection and EHR subsystems).</li>
</ul>
<p><b>Compensation:</b></p>
<ul>
<li>Pay: $150,000 - $200,000 annually. Compensation depends on location, qualifications, and experience.</li>
<li>Position may be eligible for an Annual Incentive Plan bonus of 10%-25% depending on role level.</li>
<li>Management level positions may be eligible for sign-on and relocation bonuses.</li>
</ul>
<p><b>Benefits:</b></p>
<p>
The following benefits are available, subject to employment status:</p>
<ul>
<li>Medical, dental, vision, disability, life, AD&amp;D and business travel insurance</li>
<li>Manager Time Off &ndash; 20 days per year</li>
<li>Discretionary 401k with up to 6% employer match</li>
<li>10 paid holidays per year</li>
<li>Health savings accounts, healthcare &amp; dependent flexible spending accounts</li>
<li>Employee Assistance program, Employee discount program</li>
<li>Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder &amp; childcare, auto &amp; home insurance.</li>
<li>For Colorado employees, paid leave in accordance with Colorado&rsquo;s Healthy Families and Workplaces Act.</li>
</ul>
<p>#LI-JR1</p></div>

TPR National Director, Revenue Cycle - Remote based in the US

Med-Metrix

Job Purpose
<br>The Director, Revenue Cycle Management is responsible for managing all operational aspects of our AR outsourcing engagements including overseeing their teams and maintaining a positive relationship with their clients.
<br><br>
Duties and Responsibilities
<br><ul>
<li>Provide assistance/resolution to external and internal client inquiries</li>
<li>Prepare reports or logs as required</li>
<li>Act as a technical expert in regards to financial class responsibility, to answer questions raised by clients and team members</li>
<li>Maintain a current working knowledge of all healthcare related issues and regulations especially Government payors</li>
<li>Responsible to report any detected trends in payments or denials, as well as procedural problems, to the client. Recommendations regarding the correction of these trends and/or problems should also be reported.</li>
<li>Managing the performance of client specific service level agreements (SLAs) and/or key performance indicators (KPIs)</li>
<li>Maintain a professional attitude and confidentiality at all times</li>
<li>Learn and comply with organizational and departmental policies and procedures</li>
<li>Establish realistic goals and priorities concurrent with organizational objectives</li>
<li>Adhere to all company policies and procedures including, but not limited to those identified within the Standards of Business Conduct and the Employee Handbook, as may be amended from time to time. Adhere to all applicable laws and regulations and the company's governance/compliance program.</li>
<li>Responsible for reporting violations of the company's policies and procedures, Standards of Business Conduct, governance program, laws and regulations through the company's Help Line or other mechanism that may be available at the time of the violation. Assist with internal control failure remediation efforts.</li>
<li>Ensure concerns with internal control design or performance and process changes that impact internal control execution are communicated to management</li>
<li>Possess a full and complete understanding of the internal control requirements within their area of ownership/responsibility. Responsible and accountable for internal control implementation and performance within their area of ownership/responsibility. Ensures proper internal control change management protocol is followed and communicated.</li>
<li>Responsible for ensuring that remote client access to is disabled for terminated or transferred employees when applicable in a timely fashion</li>
<li>Other duties as assigned</li>
<li>Understand and comply with Information Security and HIPAA policies and procedures at all times and ensure all direct reports are trained and in compliance of said policies and procedures at all times</li>
<li>Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards and enforce such for all direct reports</li>
<li>Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties for your respective team</li>
</ul>
Qualifications
<br><ul>
<li>Bachelor’s Degree required</li>
<li>10 years minimum experience in a hospital or physician billing business office setting or similar setting required</li>
<li>7 years minimum experience managing physician receivables in an Acute care setting or similar setting required</li>
<li>Prior Management experience required</li>
<li>Knowledge of governmental, legal and regulatory provisions related to collection activity</li>
<li>Knowledge of insurance company practices regarding reimbursement</li>
<li>Ability to work well individually and in a team environment</li>
<li>Must be reliable, responsible, goal oriented and flexible</li>
<li>Proficiency in Microsoft Office Suite</li>
<li>Strong interpersonal skills, ability to communicate well at all levels of the organization</li>
<li>Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses</li>
<li>High level of integrity and dependability with a strong sense of urgency and results oriented</li>
<li>Excellent written and verbal communication skills required</li>
<li>Gracious and welcoming personality for customer service interaction</li>
</ul>
Working Conditions
<br><ul>
<li>Occasional travel to client locations</li>
<li>Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.</li>
<li>Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.</li>
<li>Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.</li>
<li>Work Environment: The noise level in the work environment is usually minimal.</li>
</ul>
Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.

Director, Revenue Cycle Management- Remote

Faculty Physicians Inc.

<div><p>Directs and coordinates all activities pertaining to the billing division through general or direct supervision of Reimbursement Operations. Responsible for patient services, registration quality, insurance verification, payment posting, documentation imaging, claims processing and edits; and other duties as assigned.</p>
<p>
EDUCATION and/or EXPERIENCE</p>
<ul>
<li>BA in related field combined with minimum five years of managed Care experience</li>
<li>Minimum three years management experience and at least two years administrative experience</li>
<li>Knowledge of back and front office operations</li>
<li>Knowledge and understanding of FPI contracts</li>
<li>Knowledge of inpatient, critical care, emergency and/or outpatient procedures</li>
<li>Current knowledge of GE/IDX, EPIC or similar computerized billing system</li>
<li>Knowledge of ICD-10 and CPT coding</li>
<li>Strong customer service skills</li>
<li>PC proficiency</li>
</ul>
<p><i>Total Rewards</i><br>
The referenced base salary range represents the low and high end of University of Maryland&rsquo;s Faculty Physician&rsquo;s Inc. salary range for this position. Some candidates will not be eligible for the upper end of the salary range. Exact salary will ultimately depend on multiple factors, which may include the successful candidate's geographic location, skills, work experience, market conditions, internal equity, responsibility factor and span of control, education/training and other qualifications. University of Maryland Faculty Physician&rsquo;s Inc. offers a total rewards package that supports our employees' health, life, career and retirement. More information can be found here: https://www.umfpi.org/jobs/summary-employee-benefits.</p></div>

Assoc. Director Reimbursement Ops- Practice Operations- Remote Opportunity

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