Staff members from Prism health North Texas Oak Cliff Health Center Clinic

Senior Director of Revenue Cycle JobDallas, TX

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Why You'll Love This Job

Client Organization Overview:  AIDS Arms, Inc., d/b/a Prism Health North Texas and Uptown Physicians Group was founded in 1986 to provide vital services during the AIDS crisis. Since that time, the organization has grown from a staff of three to now over 250 full-time positions, including physicians, mid-level practitioners, dentists, case managers, and care coordinators. Through the recent acquisition of Uptown Physicians Group, a thriving primary care practice, the organization now maintains two different medical systems, one dedicated towards community healthcare, and the other focused on high-quality primary care. The organization manages a diverse federal, state, and local grant portfolio totaling over $12 Million annually. Program services revenue received from third party insurance, patient charges, and pharmacy rebates totals $115 million annually.  The organization currently operates eight health centers in North Texas and employs a finance and accounting staff of 20. Annual patient visits total in excess of 30,000 per year. In 2022, the organization will be submitting its application to receive a Federally Qualified Health Center Look-a-Like designation.
Core services include primary medical care for people in the LGBTQ+ community, HIV Outpatient Medical Care, dental care, psychiatry and behavioral health counseling, adult and child dental care, insurance assistance and Marketplace enrollment services, case management, prevention services, clinical research, outreach, and education, and special programs for the homeless and re-entry populations. The organization also leads in many national advocacy efforts through a partnership with AIDS United and maintains national recognition from both the HIV Medical Association and the National Institutes of Health. AIDS Arms, Inc. was recently showcased as one of only seven Ryan White funded recipients demonstrating excellence in strategies to HIV care in the HRSA Program Biennial report for 2021.
Position Summary: The Senior Director of Revenue Cycle manages all functions of the organization’s billing and revenue cycle to maximize cash flow from non-grant revenue by maintaining excellent relationships with all key stakeholders including patients, providers, administrative staff, billing companies, and health plan representatives. This role will oversee all the day-to-day operations on issues related to the revenue cycle functions, provide critical analysis, produces summarized financial dashboards, and develops team-based support to ensure redundancy for all critical functions.

Responsibilities

Responsibilities
  • Manage the entire revenue life cycle from strategic planning to tactical activities to high performance, integrity, and achievement of financial goals
  • Implement, design, and provide support for business and administrative analytics within revenue cycle functional areas
  • Delegate responsibilities of various revenue cycle components to different members of both the internal billing and external clinical staff and maintain a system of accountability across all domains
  • Create accurate forecasts and analyses of billing revenues and maintain up-to-date reporting requirements of different audiences, including executive leadership and board of directors
  • Develop and maintain dashboards with key performance indicators, metrics, data points and formulas
  • Develop processes and policies for exception handling, appeals and denials as it relates to billing and invoicing
  • Communicate and collaborate with operational teams to conduct training around proper entry for patient registrations and other data to assure all information is collected that is needed for billing
  • Monitor and report ongoing performance under the contract related to administrative requirements, claims processing lags, denials, bad debt and other key indicators
  • Interpret and summarize information, performing statistical test and analysis
  • Evaluate, identify, and resolve payor A/R issues
  • Work with internal revenue cycle and administrative teams to identify and manage 3rd party payor denials, overpayment, and underpayment issues
  • Monitor the performance of all 3rd party billing entities
  • Serve as a resource along with the Internal Audit and Compliance team(s) for department billing staff regarding accurate CPT/ICD10 coding
  • Serve as a consultant across functional leaders and Admin staff and remaining up to date of new and emerging reimbursement and market trends as it relates to various commercial and federal/state-managed health plans
  • Optimize existing technologies within the revenue cycle relating to charge capture, coding, billing, and clinical trials to achieve the highest level of automation and integration
  • Develop departmental strategies to meet cash projection formulas, reduce days in accounts receivable, and reduce denials
  • Discover the root cause of data flow issues, recommend changes, and assist with the resolution
  • Perform database editing/auditing functions to maintain and improve data quality
  • Determine how processes can be aligned with best practices to achieve optimal results, measurable change, and quantifiable, positive contribution
  • Assist in the identification of new technologies that will improve departmental operations and takes a leadership role in any new technology implementation
  • Performs other duties as needed

Skills & Qualifications

Job Requirements
  • Bachelor’s degree in a related area
  • Minimum of 7 years’ experience in revenue cycle management, patient financial services, charge capture and health information systems is required
  • Minimum of 5 years’ prior revenue cycle experience in a multi-specialty office-based environment is required
  • Knowledge of Texas Medicaid rules, including billing and credentialing
  • Thorough understanding of primary care, behavioral health, counseling, and dental billing practices and procedures, including knowledge of state, local and federal laws
  • Confidence to present complex information to diverse stakeholders
  • Ability to relate and communicate positively, effectively, and professionally with internal and external stakeholders
  • Work calmly and respond courteously under pressure
  • Collaborate and accept direction
  • Exhibit strong verbal and written communication and demonstrates excellent customer service skills
  • Ability to be adaptable, working with challenging and demanding tasks and customers
  • Ability to quickly evaluate and prioritize tasks in a fast-paced environment
  • Demonstrate detail-orientation and superior time management skills
  • Proficiency in MS Office (Word, Excel, PowerPoint), with strong data entry skills
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