Vice President of Revenue Cycle Management

Unifi (Indiana, USA) Follow 28 days ago

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The Vice President of Revenue Cycle Management (VP of RCM) is responsible for directing all facets of the organization's revenue cycle operations, encompassing patient intake, insurance eligibility validation, securing treatment authorizations, medical coding, claims submission, payment collection efforts, and appeals processing. This executive-level position is pivotal in devising and enforcing strategies that optimize reimbursement and revenue attainment while rigorously upholding compliance with regulations and requirements mandated by payer entities.

Essential Duties and Responsibilities

Formulate and execute strategies aimed at optimizing the revenue cycle from the initial patient onboarding stage through the final payment receipt
Provide overarching leadership and management oversight across all revenue cycle departments, including patient intake, insurance verification, authorization procurement, coding, billing, collections, and appeals processing
Establish performance metrics, key performance indicators, and reporting mechanisms to monitor revenue cycle operations and pinpoint opportunities for enhancement
Uphold organizational adherence to payer rules, regulations, and mandates across the entirety of revenue cycle functions
Maintain comprehensive, expert-level proficiency in insurance plans, coverage policies, authorization criteria, coding guidelines, and reimbursement models specific to ABA services
Cultivate and manage relationships, as well as negotiate contracts, with payer organizations
Develop and implement robust denial prevention protocols and appeals management programs
Leverage data analysis and reporting to identify revenue leakage areas and implement process improvements to rectify gaps
Recruit, train, coach, and foster the professional development of high-caliber revenue cycle staff

Requirements

Knowledge, Skills, and Abilities

Comprehensive expert-level knowledge of medical coding, billing regulations, reimbursement models, insurance plans, coverage policies, authorization requirements, and healthcare compliance/regulatory landscape for ABA services
Proficiency in data analysis, reporting, and leveraging data to identify revenue leakage and drive process improvements

Strong strategic planning capabilities to develop and implement revenue cycle optimization strategies and denial prevention/appeals management programs
Excellent communication, presentation, and relationship management skills for working with payer organizations
Leadership abilities to oversee and manage cross-functional revenue cycle departments, ensure organizational compliance, and drive performance
Skilled in hiring, training, coaching, and developing high-performing revenue cycle teams
Expertise in process improvement and operational optimization across the full revenue cycle continuum

Experience and Education

A bachelor's degree is required, with a master's degree or relevant certification being preferred. In lieu of a degree, fifteen years of RCM work experience will be considered
7-10 years of revenue cycle leadership experience required, with experience in the ABA industry strongly preferred

Benefits

Competitive salary
Fully remote position
Generous paid time off and paid holidays
Medical, dental and vision insurance
401k with company match
On-going support
Opportunity for career advancement
We genuinely care about our team members

UNIFI is an equal opportunity employer, and we value diversity. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital or partnership status, military status, or disability status, or any other characteristic protected by law