Director, Revenue Cycle

St. Elizabeth's Medical Center
United States, Massachusetts, Brighton
Mar 25, 2025
The Director of Revenue Cycle will work with departments throughout the hospital to support patient financial services, promote a positive environment and meet hospital goals. He/she will provide leadership and managerial support for all functions and areas within Patient Access. Key Responsibilities: Provide leadership and managerial support to pre-registration, registration, residual collections, bed placement, and insurance eligibility/benefits verification, pre- authorization, community wide scheduling, and financial counseling. Maintain knowledge of all patient access areas ensuring high productivity and performance. Maintain properly functioning revenue cycle processes through a cooperative, cross departmental network Focus resources on improving interdepartmental processes to improve patient throughput, reduce denials and enhance patient accounting operations Achieve annual goals of revenue cycle performance Work with management and hospital departments to improve processes, increase accuracy, create efficiencies, resolve related issues and achieve overall goals of the department. Perform XClaim and Revenue Recover training in revenue cycle systems for new users and monitor departmental clean-up of work lists. Monitor high dollar and aging accounts in systems for escalation with departments (DNFB, XClaim, Revenue Recover, RTS). Assist departments with resolving batch rejections daily. Review and ensure departments are reconciling charges on a daily basis. Follow up on claims and appeals including interaction with payers as needed. Interact with departments and physicians' offices to understand the processes and services they provide, as well as their needs. Maintain and enforce all departmental policies while ensuring compliance with all regulatory and accreditation agencies. Make suggestions for process improvements and develop plans to successfully implement. Ensure all compliance and audit requirements are understood, consistently followed and current in tracking and monitoring requirements. Participate on revenue cycle team and all other hospital-based teams as required. Attend monthly Patient Access Management meetings to provide feedback and address open items with local management on revenue cycle activities being completed within the facilities. Work with management and hospital departments to improve processes, increase accuracy, create efficiencies, resolve related issues and achieve overall goals of the department. Support of Patient Access, HIM, and Revenue Cycle FTEs Manage schedules and process Kronos for all staff Discipline staff and work the union and HR to manage staff Actively post, interview, and hire for all open positions Backfill any gaps in coverage Oversight of patient throughput Oversight of DNFB/DNFC/Clean Claims Ensures all lists are maintained and cleaned daily Support any open projects amongst all departments Update Research Accounts and work with Research groups to support best practice Support new Revenue Cycle Opportunities Actively coordinate for post RCM TSA Coordinate Conifer integration through training and reporting Coordinate PWC integration training and reporting Advocate for any necessary outstanding vendors Identify perceived gaps in process post TSA and problem solve or create work arounds Assist in developing a workflow and escalation for the new PAC team Work with integration to produce realistic solutions for new vendors, workflows, and issues as they arise Meet with Privacy Officer and Billing Compliance to support any issues as they arise Actively supporting all team members with day to day questions Coordinate with other departments to assist with any Patient Access, Revenue Cycle, and HIM needs Required Knowledge and Skills: Knowledge of CPT, HCPCS, and ICD-10 coding Strong analytical skills In-depth knowledge of healthcare are billing and collection practices. Education/Experience: Bachelor's degree in Business or Accounting preferred Minimum 5 years supervisory experience in a healthcare setting preferred Equal Opportunity Employer/Disabled/Veterans