Revenue Cycle Director (Laboratory)

SUMMARY OF ROLE:

Serve as a subject matter expert on all issues related to clinical laboratory billing, collections, national insurance analysis, and revenue cycle management. Responsible for managing the revenue integrity work including over/under payments, appeals, payer issue resolution, system management and reporting. Operates in a liaison capacity within the Company and with external inquiries such as audits, consulting engagements and surveys. Manages the clinical laboratory billing and coding team. Responsible for departmental policies and procedures, providing recommendations when appropriate and ensuring compliance.

Essential Duties and Responsibilities:

• Manage audits of medical/laboratory and related billing/reimbursement records in order to evaluate their accuracy and compliance with Health System policies, government regulations and third party payer contracts
• Provide leadership to a team that works to achieve transformative levels of financial and operational performance through improving revenue collection systems and evaluating operational processes to determine and develop best practices for the organization.
• Ensure billing compliance including establishing RPC’s and appropriate CPT coding for all ordered and billed tests
• Direct all revenue cycle functions including billing and follow-up, insurance verification, and related activities in a manner that minimizes days in accounts receivable while maximizing revenue realization.
• Foster a collaborative and highly accountable culture that results in high levels of internal and external customer satisfaction, billing accuracy and cash collections for laboratory billing.
• Ensure compliance with regulatory and contracting requirements and maximization of revenue realization for services provided.
• Collaborate with corporate accounting for oversight of funds flow back to practices for smooth and expedient auto-posting.
• Play an integral role in the development and implementation of the organization's technology plan, including significant contribution to patient accounting and EMR upgrade conversations.
• Develop, implement and report on measures of success and efficiency for departmental critical processes and workflows.
• Integrate new client locations into revenue cycle model.
• Maintain knowledge of updated laws and regulations and each state for each insurance carrier.
• Demonstrate expert knowledge and understanding of CMS guidelines and clinical lab billing and coding.
• Initiate and lead in payer engagement discussions to resolve outstanding claims

Minimum Qualifications:

• Bachelor’s degree in healthcare administration, finance, business administration, or related field.
• Minimum five years' experience as a Revenue Cycle Director.
• At least five years of experience managing national claims, billing, and collections for clinical laboratory.
• Extensive knowledge of CMS guidelines.
• Proficient in medical office software.
• Extensive knowledge with coding and billing regulations, relevant healthcare regulations and HIPAA.
• Extensive knowledge of health insurance providers.
• Strong interpersonal, organizational, and analytical skills.
• Excellent customer service skills.
• Ability to multi-task and remain agile.

Preferred Qualifications:

• Master’s degree in healthcare administration, finance, business administration, or related field.
• Ten plus years of experience as a Revenue Cycle Director with a speciality in laboratory services.

Disclaimers: This job description is not all inclusive of duties, other responsibilities can be added and modified based on business needs at any time, with or without notice.

EEO Statement

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

ADA Statement

The Americans with Disabilities Act (ADA) and the Americans with Disabilities Amendments Act (ADAAA) are federal laws that require employers with 15 or more employees to not discriminate against applicants and individuals with disabilities and, when needed, to provide reasonable accommodations to applicants and employees who are qualified for a job, with or without reasonable accommodations, so that they may perform the essential job duties of the position.

It is the policy of Fast Lab Tech to comply with all federal and state laws concerning the employment of individuals with disabilities and to act in accordance with regulations and guidance issued by the Equal Employment Opportunity Commission (EEOC). Furthermore, it is the company policy not to discriminate against qualified individuals with disabilities in regard to application procedures, hiring, advancement, discharge, compensation, training or other terms, conditions and privileges of employment.

*We offer Competitive Salary, Flexible Hours, and Remote Work