Director Revenue Cycle Management

Director Revenue Cycle Management

Location: King of Prussia PA

Organization: Premier Orthopaedics in partnership with Philadelphia Hand to Shoulder

Overview

Premier Orthopaedics in partnership with Philadelphia Hand to Shoulder is seeking a dedicated and skilled Director of Revenue Cycle Management to join our team at our King of Prussia office. As two of the regions most respected providers of orthopedic and upper extremity care we offer a collaborative patient-focused environment that prioritizes clinical excellence innovation and ongoing professional development.

Position Summary

The Revenue Cycle Director is responsible for overseeing and optimizing all aspects of the revenue cycle to ensure strong financial performance regulatory compliance and efficient operations. This role provides strategic and operational leadership for accounts receivable billing collections payor relations and reimbursement functions. The Director analyzes key performance metrics implements process improvements manages vendor and payor relationships and develops high-performing teams to drive accuracy maximize cash flow and support organizational goals. This is a full-time on-site MondayFriday position.

Key Responsibilities

• Manages the day-to-day operations of the revenue cycle functions to optimize performance and quality levels while ensuring the most efficient use of resources.
• Monitor accounts receivable activity and initiates appropriate corrective measures as needed. Communicates performance data and associated action plans to Senior Leadership.
• Identifies and implements processes to achieve key revenue cycle metrics including but not limited to A/R Days Unbilled A/R Denial Percentage and Cash Collections.
• Analyze large volumes of data and provide financial analysis and regularly presents trends movements and status to Senior Leadership.
• Review billing work queues regularly to ensure that workloads are distributed evenly and that the department metrics are being met.
• Manages self-pay receivables including vendor relationships to help resolve AR. Inclusive of self-pay receivables is the process of charity review and bad debt management.
• Develop and implement policies and procedures for designated areas; evaluate new systems and methods and recommend changes as necessary.
• Maintains comprehensive knowledge of 3rd party billing requirements and reimbursement principles. Also maintains comprehensive working knowledge of payor contracts and ensures that payors are billed according to contract provisions and communicates with payers on escalated issues.
• Reviews and implements changes to electronic claims formatting when appropriate.
• Conducts regular meetings with staff to discuss third-party reimbursement methodologies. Provides direction to staff on changes in managed care reimbursement and expectation of changes in insurance guidelines.
• Keeps abreast of compliance regulations standards and directives regarding governmental/regulatory agencies and/or third-party payers. Ensure communication and education of such to the Billing department as well as other Revenue Cycle Leaders.
• Provide tools for Team Leads and Managers to sustain develop enforce and report department standards and metrics; recommend actions for improvement.
• Responsible for accurate and timely application of transactions including adjustments and write-offs.
• Research and resolve discrepancies in a timely manner.

Qualifications

Education: Bachelors degree or an equivalent combination of education and relevant experience.

Licenses & Certifications: Professional certification in revenue cycle coding or healthcare financial management preferred (e.g. CRCR CPC CPB HFMA).

Experience

• Minimum of five (5) years of experience in a leadership role in healthcare revenue cycle operations; experience supporting professional billing preferred.
• Experience with Athena EMR highly preferred.
• Orthopaedic billing experience strongly desired.
• Previous management experience with demonstrated ability to lead motivate and develop high-performing teams.

Knowledge / Technical Skills

• Strong knowledge of claims processing and claim editing systems.
• Comprehensive understanding of Medicare and Medicaid payer guidelines across multiple states.
• Knowledge of CPT HCPCS and ICD diagnosis coding.
• Knowledge of medical terminology and front- and back-end revenue cycle workflows.

Competencies

• Strong analytical and problem-solving skills.
• Ability to build and maintain effective working relationships with employees patients and providers.
• Positive leadership style with the ability to influence and drive performance.

Compensation & Benefits

• Comprehensive benefits package including medical dental and vision plans
• 100% employer-paid life insurance
• 401(k) with employer match
• Benefits begin the first of the month following hire date (for full-time employees)
• Generous paid sick and vacation time
• 7 paid holidays annually
• Opportunities for growth and advancement
• Employee referral reward program

About Premier Orthopaedics & Philadelphia Hand to Shoulder

Premier Orthopaedics and Philadelphia Hand to Shoulder Center (PHSC) are leading providers of comprehensive musculoskeletal care throughout Pennsylvania New Jersey and Delaware.

Premier Orthopaedics delivers expert treatment for orthopedic injuries joint disease interventional spine care regenerative medicine and comprehensive physical therapy services supported by more than 150 providers across 50 locations. Our facilities include state-of-the-art MRI centers outpatient surgery centers physical therapy clinics and orthopedic urgent care centers to ensure timely access to high-quality patient-focused care.

Philadelphia Hand to Shoulder Center (PHSC) a division of Premier Orthopaedics has been nationally recognized for more than 50 years for its specialized care of the hand wrist elbow arm and shoulder. Our fellowship-trained surgeons and certified Hand and Occupational Therapists collaborate to provide seamless carefrom diagnosis and treatment to post-operative and rehabilitative recovery. With 14 convenient locations across Pennsylvania and New Jersey PHSC offers advanced integrated care to restore function mobility and quality of life for patients with upper extremity conditions.

Required Experience:

Director