Vice President - Revenue Cycle Management

  • Lake Mary, FL 32746, USA
  • Full-time

Company Description

 

Here at Cinq Recruitment, we believe in finding the right fit, for you and our clients. Whether you seek long-term employment solutions for your business or your next career move, we understand the importance of individual and business needs. With over 30 years of successful staffing and recruiting experience, we excel at providing passive candidates with the right skills and cultural fit for specialized positions. Here is the opportunity to work with an exciting pharmaceutical company. 

 

Job Description

Essential Functions:

·  Oversee companywide efforts to improve KPIs, including timely and accurate billing, high volume reimbursement and collections, accounts receivable balance reduction, and timely cash application processes. Develop and maintain policies, procedures and work instructions aligning functional teams and leadership around these goals; in accordance with legal and regulatory requirements.

·  Maintain expertise of government reimbursement guidelines, and billing requirements.

·  Develop and execute a plan to coordinate RCM functions under one leadership team. Establish comprehensive and combined policies, procedures and work instructions, providing a common reference for functional RCM teams. Sustain RCM policies and procedures; 

·  Build sustainable results and performance improvement that support business strategy through consideration of the needs and challenges faced by the RCM Team coupled with a clear understanding of the priorities, focus and emergent issues of other functions and teams across the enterprise.

·  Work with Business Analytics and Finance teams to construct, test and roll out enhanced metrics. Conduct scheduled reviews of key performance metrics around financial, activity and quality indicators to identify, communicate, and address performance gaps through team involvement in root cause analysis and design and implementation of well-reasoned permanent solutions.

 ​​

Qualifications

MUST HAVE:

·  Experience unifying teams and procedures under revenue cycle umbrella (multi-site) to operate as a single cohesive unit

·  Ability to create procedures, metrics, and KPIs to evaluate performance and efficacy of RCM team as a unit

·  Ability to merge RCM functions with finance and operations team. 

·  Be able to signify a broader view of RCM

·  Procedural knowledge regarding the following insurance payer types:

o PBM/medical

o Major Medical billing

o Managed Care

o Med B

 

Education/Experience Requirements:

·  Bachelor’s degree in Finance, Accounting of Similar Discipline

·  Knowledge of medical benefits and insurance standards, investigation processes, and compliance requirements for reimbursement.

·  Exposure to billing and reimbursement for home infusion. Medicare and Medicaid reimbursement and pharmacy claims. Substantial understanding of rejection codes, varied appeals levels, and appropriate response plans when working with government or commercial payers.

·  Min 8 years experience in a multi-regional RCM leadership position in the healthcare industry.

Additional Information

All your information will be kept confidential according to EEO guidelines.

US CITIZEN OR GREEN CARD Holder- Must have a clean criminal background

Pay Rate: $150,000 - $200,000 + 15% MIC Bonus per year