Director of Revenue Cycle

Granger Medical Clinic is one of the largest independent physician-owned medical clinic groups in Utah. At Granger Medical Clinic exceptional care comes from all of us. Our mission is to provide exceptional healthcare for patients and their families with a lifetime commitment to quality compassion and respect. We understand that our personnel play a major role in doing so and we are looking for a Director of Revenue Cycle whose values and mission aligns with ours.

The general purpose of the Director of Revenue Cycle Management is to develop and direct the revenue management strategies tools and interfaces and to oversee the implementation of these strategies. This position will proactively identify develop and execute critical process improvement initiatives to drive best practice performance and favorably impact accounts receivable cash acceleration and net revenue.

Essential Functions and Duties:

• Participate in the strategic planning and ongoing development of the Revenue Cycle function.
• Drive and support hybrid reimbursement models including process redesign to enable new clinical care models and enterprise-wide technology integration.
• Develop refine and monitor key performance indicators (KPIs) for Executive Management review including payer mix accounts receivable (A/R) collection rates adjustments bad debt write-offs estimated collections appeal success rates and other relevant metrics.
• Maintain comprehensive knowledge of revenue cycle operations and regulatory requirements across governmental managed care and commercial payers.
• Serve as the subject-matter expert on regulatory compliance and legal requirements related to medical billing and CMS ensuring adherence to all applicable regulations standards and third-party payer directives.
• Develop and maintain internal controls to optimize revenue recovery by identifying charge capture coding and reimbursement gaps and recommending and implementing corrective solutions.
• Monitor accounts receivable performance to ensure aging categories align with established targets and national benchmarks.
• Ensure effective management of claim denials including root-cause analysis and corrective action.
• Oversee the identification management and appeal of underpayments from insurance carriers.
• Ensure payer contracts are current accurately loaded and maintained within the contract management system for ongoing monitoring.
• Establish and monitor departmental goals and objectives including productivity standards for all revenue cycle staff.
• Ensure a standardized process is in place for reviewing approving and issuing refunds.
• Collaborate with registration leadership to maximize workflow efficiencies and ensure accurate and timely entry of demographic and insurance information.
• Propose evaluate and analyze (including ROI) new technologies and process improvements to enhance revenue cycle efficiency and accuracy.
• Assist in the development of annual departmental budgets and ensure operations remain within approved financial parameters.
• Ensure staff are educated and trained on new technologies performance goals and payer contract requirements.
• Establish and lead regularly scheduled revenue cycle meetings to review performance align strategies and communicate departmental direction.
• Partner with C-Suite leadership to identify payer relationship issues and support contract negotiations and renegotiations.
• Ensure timely and accurate reporting and analysis of physician revenue for each provider.
• Perform additional duties and special projects related to revenue cycle operations as assigned or directed by Executive Management.

Qualifications:

• Experience: Minimum of 8 years in healthcare revenue cycle management with at least 3 to 5 years in a senior management role (director or above) managing staff of professionals in the revenue cycle environment.
• Education: Bachelors Degree preferably in Business Administration Health Administration Accounting and/or HIS. Masters degree preferred. CPC preferred.
• Special Qualifications: Proficiency with spreadsheet and word processing software; experience with eClinicalWorks working knowledge of healthcare revenue cycle principles and functions; excellent analytical skills; excellent verbal and written communication skills ability to lead and manage a group of employees.

Granger Medical Clinic offers competitive wages potential for annual bonus and excellent benefits. Benefits include:

• Vision
• Dental
• Medical
• Sick Leave
• Paid Time Off
• Life Insurance
• Paid Maternity Leave
• Tuition Reimbursement
• Short- and Long-Term Disability
• Employee Assistance Program (EAP)
• Health Savings and Flexible Spending Accounts
• 401(k) with a Company Match Profit Share and Safe Harbor Contributions

Granger Medical Clinic provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race color religion sex national origin age disability or addition to federal law requirements Granger Medical Clinic complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment including recruiting hiring placement promotion termination layoff recall and transfer leaves of absence compensation and training.

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regards to race color religion gender sexual orientation gender identity

national origin age disability status genetic information and testing Family & Medical Leave protected veteran status or any other characteristic protected by law.

Required Experience:

Director