Illume Fertility (formerly RMA of CT) specializes in the treatment of infertility, including assisted reproductive technologies (ART) like intrauterine insemination (IUI), in-vitro fertilization (IVF), and pre-implantation genetic testing (PGT). Illume Fertility is Fairfield County's largest fertility clinic and egg donation center and is led by eight board-certified reproductive endocrinologists. Illume Fertility is consistently recognized as an LGBTQ Healthcare Equality Leader and its Integrated Fertility & Wellness program offers holistic support via acupuncture, mental health counseling, support groups, and nutritional counseling. lllume Fertility has 5 convenient locations in Norwalk, Danbury, Stamford and Trumbull, CT, and Harrison, NY.
Position Overview:
We are looking for a Director of Revenue Cycle Management to promote Illume Fertility's core values and commitment to teamwork in all endeavors. This role will have multiple departments reporting directly to them. The Director is responsible for overseeing all aspects of the revenue cycle process and ensuring that revenue cycle operations are efficient, and accurate and Key Performance results are met. We are looking for Talented and highly motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of family building.
Duties and Responsibilities:
Supervise closely all vertical departments that report to you, which include Verification of Benefits, Pre-certification, Financial Counseling, Charge Entry, Cash Poster and the Accounts Receivable teams to promote and develop productivity within each department
Ensure departmental workflow efficiencies, adherence to internal controls, policies, and procedures
Provide continuous feedback to organization leadership team, specific to each vertical
Provide monthly reporting on denial trends, monthly reporting on Insurance aging buckets, monthly reporting on outstanding self-pay aging AR
Lead weekly meetings with each manager from the various vertical departments, provide feedback and resolution
Proactively review accounts for analysis on insurance reimbursements, determine when appropriate opportunities for fee schedule increases
Drive practice billing/AR KPI's to reach established targets
Set performance goals, Key Performance Indicators (KPIs), and benchmarks for revenue cycle operations. Monitor performance metrics, analyze trends, and implement performance improvements initiatives
Develop long-term relationships and lead though influence with key resources at payers to help drive down organization outstanding AR
Identify and troubleshoot billing and payer issues by analyzing denials, aging AR and payer feedback
Understand national payer guidelines, large local payer guidelines, coding requirements, and billing related regulatory requirements to guide RCM teams on best practices
Identify root causes and trends leading to aging AR and identify how to proactively address
Be familiar with insurance portals to maximize the use of ins systems by all teams, related to claims reprocessing, verification of benefits, appeals
Maintain Continual knowledge of payor policies to assure optimal reimbursement for all services
Partner closely with accounting regarding revenue recognition, cash projections, and providing detailed accounts receivable and collection data for month end closing
Support in month end closing data, reports
Create best practices for resolving patient AR including creating workflows that can be done pre and post visit to address AR build up
Maintain relationships with key clinical stakeholders in the organization, allowing for a better understanding of best billing practices
Must work collaboratively with other leaders in the organization
Interface with physicians as needed regarding any RCM updates, answer questions on billing related items and help ensure effective communication between the providers and RCM team
Effective communication abilities for phone contacts with insurance payers to resolve issues
Maintain the highest degree of ethics when handling patient payments, communication with patients
Analyze Contracts for opportunities in billable services and or rate increases
Support auditors and the accounting department, by providing necessary review of systems and identifying instances when refunds should be issued
Meet positional metrics and benchmarks
Follow all department standard operating procedures carefully and accurately
Other duties as assigned by the Managing Director
Qualifications
Minimum 8+ Years of Leadership experience, as a Director, Associate Director, Sr Manager, Bachelor's Degree in health care administration preferred
Minimum 8 + Years experience in complex billing functions, fertility experience preferred
Strong understanding of revenue cycle processes, including billing, coding, verification of benefits, authorization requirements for the field of infertility, denials management and collections
Proficiency in data analysis, financial reporting, and revenue cycle analytics to identify trends, KPIs
Must be comfortable charting large data sets and summarizing trends
You can leverage technology to advance workflows
Proven ability to lead and develop a team and drive performance improvement, demonstrated by KPI metrics being met
Data driven and process oriented, able to simplify complex concepts
Strong communication skills to effectively communicate with organization leadership, clinical departments, and other stakeholders
Demonstrate process improvement, project management, workflow, and benchmarking for organization
Immunization:
Staff member must meet immunizations requirements as stated in the Illume Fertility immunization policy.