The Associate Director of Revenue Cycle Management (ADRCM) is responsible for all aspects of the revenue cycle workflow including Insurance Contracting, Credentialing, Eligibility, Claims Submission and Follow-Up, Payment Application, Denial Management. The ADRCM is responsible the setup, maintenance and effective operation of the electronic billing system and clearinghouse. Supervises billing staff and provides professional leadership and direction.
Essential Duties and Responsibilities
Revenue Cycle Management
- Development, implementation and administration of all policies and procedures relating to the revenue cycle
- Ensure compliance with current state, federal and insurance regulations of all billing and reimbursement practices
- Work collaboratively with Human Resource Department to facilitate initial credentialing process
- Implement revenue cycle improvements as necessary to obtain maximum reimbursement
- Actively monitors accounts receivable and denials to ensure appropriate collection practices
- Performs ongoing trend analysis on third party payments to ensure that reimbursement is in accordance with allowable amounts stated in agreements and contracts
- Actively participates in staff development and training in appropriate billing related topics
- Performs ongoing trend analysis on third party rejections and denials
- Provides oversight of initial and ongoing credentialing process for all provider types and facility
- Monitor and collaborate with CFO to make decisions on the value and collectability of accounts receivable.
- Prepares regular reports and analysis pertaining to A/R
- Initiate, review and maintain contracts with 3rd Party payers including amendments and rate negotiation when applicable
- Collaboratively establishes and monitors standards for controlling registration flow as well as the integrity and quality of data throughout the revenue cycle
- Assist CFO and Behavioral Health leadership in analyzing and implementing value-based payment initiatives
- Direct supervision of Billing Staff
- Facilitates staff development and assures that staff is appropriately trained to meet the organization requirements and all regulations.
- Provides leadership to organization staff by example, by knowledge and practice of professional skills, relationship and standards.
- Assures appropriate staffing by recruiting, interviewing, and recommending candidates for positions in accounting.
- Completes staff performance appraisals in a timely manner and addressing disciplinary issues through the organization progressive disciplinary process.
- Participates in organization-wide and organization-appointed committees in order to facilitate organization program initiatives and services to the community.
- Responds supportively to changes in programs and policies and taking a broad view of one’s position by assuming additional responsibilities when the need arises.
Education: Bachelor’s in related field with 5+ years in behavioral health billing management role or Associates in relevant field with 10+ years in behavioral health billing management role.
Experience: Minimum five (5) years’ experience required in a medical billing supervision. Minimum of 10 years working with NYS Medicaid, Medicare and 3rd Party payers.
- Experience in behavioral health billing preferred.
- Knowledge of NYS billing rules and NetSmart EHR preferred
- Comfortable with collecting and analyzing insurance/revenue data and reporting to management team.
- Clinical & business acumen.
- Strategic thinking.
- Customer/client focus.
- Communication proficiency.
- Time management.
- Computer/IT proficiency (Microsoft Office, Electronic Medical Record systems, etc)
- Knowledge of Medical Terminology, CPT, HCPCS and lCD-10 coding.
- Knowledge of NetSmart/RevConnect and OMH reporting is a plus.
- Knowledge of all regulatory reimbursement and insurance related requirements.
- Knowledge of procedures and revenue cycle flow in a healthcare organization.
Work Environment – Office Setting / Remote work possible
Our Agency Values
Integrity – Being honest and trustworthy
Compassion – Extending empathy and understanding to others
Hope – Believing in the strength of the human spirit and heart, to emerge and thrive in the face of challenge
Diversity – Promoting a vison of community comprised of wide-ranging assets
Respect – Treating all individuals with dignity and without judgement
Community – Recognizing and reinforcing the importance of our world as being comprised of people of differing strengths and perspectives
Justice – Promoting social and economic equity and fairness
Quality – Striving for excellence in every aspect of our work
Do you value flexibility and support in your work environment? We offer a wide variety of competitive benefits, services and programs that provide our employees the resources to pursue their goals, both at work and in their personal lives. Our benefits packages include:
- Medical/Dental Insurance
- Vision Insurance
- Life Insurance
- 403(b) Retirement Plan with employer match up to 5%
- Short and Long Term Disability
- Voluntary Benefits: Hospital, Accident, Short-Term Disability, Cancer, Vision and Dental Aflac Plans
- Vacation, Personal and Sick Time
- Tuition Discount Programs
We are an equal opportunity employer and our goal is to be a diverse workforce representative of the community we serve. Family Services follows federal, state and local laws prohibiting discrimination in hiring and employment. We do not discriminate against employees or applicants in violation of those laws.
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