Director of Revenue Cycle Management

About Local Infusion

When a patient is diagnosed with a chronic autoimmune disease, they learn that managing their disease will be a lifetime responsibility. Their whole care experience is broken. The cost, the confusion, the antiquated technology. Patients sit in cold, fluorescent-lit rooms, for several hours at a time, multiple times a year for the rest of their lives! Outside of the room, the experience isn't any warmer. Inaccurate medical bills. A lack of communication. A referral process that's lengthy and daunting. For patients and their families, this isn't just treatment—this is their life.

Our team has spent decades in the infusion and healthcare industry. We saw all the mistakes the industry was making. At every step, we thought, "there has to be a better way."  Local Infusion is a thriving healthcare organization currently operating rapidly growing centers throughout the Northeast. Our success in the specialty infusion field is driving the addition of more clinics, which will be opening over the next 12 months. As the Director of RCM, you'll play a vital role in optimizing our financial processes across all locations, contributing to our dynamic expansion in new markets.  

Come be a part of that solution and join a team that is passionate about connecting patients to the life saving care they need!

Position Overview:

The Director of Revenue Cycle Management (RCM) is responsible for leading and optimizing all aspects of the organization's revenue cycle processes to ensure financial efficiency, compliance, and exceptional patient service. This role involves overseeing billing, coding, collections, and reimbursement processes while driving operational improvements and implementing best practices to maximize revenue and minimize loss.

Responsibilities:

• Oversee end-to-end revenue cycle processes, including patient registration, billing, collections, and accounts receivable management across multiple markets

• Build, manage, and train a high-performing revenue cycle team (onshore and offshore), fostering collaboration and accountability.

• Own results and manage to KPIs (DSO, aging A/R, denial rate, time to bill, etc)

• Track and analyze financial data to identify trends, discrepancies, and opportunities for process improvement.

• Identify opportunities to streamline revenue cycle processes and implement technology solutions to improve efficiency and accuracy.

• Close the month timely, ensuring all cash is posted and reconciled

• Troubleshoot and solve issues related to revenue cycle and denial claims management 

• Collaborate with internal teams to resolve billing and payment discrepancies and address outstanding balances.

• Maintain a comprehensive understanding of fee schedules, payor policies, and managed care contracts, including Medicare and Medicaid.

• Monitor compliance with regulatory standards, including Medicare compliance, OSHA, and HIPAA, and implement necessary measures to ensure adherence.

• Demonstrate proficiency in ICD-10, CPT, HCPCS coding, referrals, pre-certification procedures, and documentation guidelines.

• Foster positive relationships with payors, patients, and internal stakeholders to optimize revenue collections and resolve issues promptly.

Requirements:

• High school diploma or GED required

• Minimum of five (10) years of billing, collections, and cash posting experience in the specialty infusion or oncology healthcare setting with at least 3 years of experience managing a team

• Strong analysis and analytical skills, complex problem solver and critical thinking skills required

• Advanced knowledge of regulatory and compliance regulations

• Comprehensive understanding of fee schedules, payor policies and managed care contracts, including Medicare and Medicaid

• Working knowledge of Medicare compliance, OSHA, and HIPAA

• Familiarity with NaviNet and Availity, as well as payer portals.

• Strong working knowledge of ICD-10, CPT, HCPCS, referrals and pre-certification procedures, as well as documentation guidelines

• Proficiency with standard office software applications

• Superior interpersonal communication skills, with the ability to develop and maintain effective relationships with a variety of both internal and external teams

• Strategic thinker who has desire to go above and beyond what is required, exhibits ownership, and dedication to the team and company’s success 

• Location is flexible but must be able to travel to Nashville ~1 per month.

• Consideration to candidates located on the East Coast