Revenue Cycle Director
Community Health Systems, Inc., Beloit, WI, United States
Revenue Cycle Director
Job Title: Revenue Cycle Director Location: Beloit, WI EEO Category: Mid/Senior Mgr Department: Administration Exempt Reports to: Chief Financial Officer Pay Grade: 8
JOB SUMMARY This position is responsible for leading and managing the policies, objectives, and initiatives across all revenue cycle operations for Community Health Systems, Inc. (CHS). The Director will oversee the strategic direction, goal setting, and performance management of the revenue cycle processes, encompassing the best practices related to the use of technology and analytics, as well as practice management processes. The position works closely with Finance and all clinical departments in the coordination of accurate data gathering, proper reimbursement, and prompt and high‑quality patient service. The Director oversees the centralized scheduling, intake, coding, and billing processes for all areas, to ensure that payor requirements are met, and the patient experience is positive.
ESSENTIAL JOB FUNCTIONS
Directs and oversees the overall policies, objectives, and initiatives of the revenue cycle activities to optimize the patient financial interaction with CHS. Specific areas of oversight are centralized scheduling, patient access (registration and benefit navigators), coding, and billing.
Propose and implement policies and procedures, work rules and performance standards to ensure the efficient and effective operation of CHS Revenue Cycle departments in compliance with organizational standards and federal, state and local laws.
Maintain appropriate internal controls over accounts receivables/cash receipts; monitor charge posting, billing, and collection operations for compliance with established policies, regulations, procedures, and standards; and establish benchmarks for “Days in Accounts Receivable” based on Federally Qualified Health Center industry standards.
Design, implement and monitor all key performance indicators to ensure that cash flow is maximized throughout the revenue cycle.
Develop, plan, organize, and implement current and future best practices for revenue cycle scheduling, intake, coding, billing, collections, denial management and other functions.
Continuously identify opportunities for enhancement of revenue capture processes and correct any operational issues that hinder the timely receipt and posting of payments and maximization of cash flow.
Collaborate and coordinate with practice managers and department directors regarding front‑desk operations related to billing, cash management, collections activities and revenue cycle processes.
Consult with Quality / Compliance Department on questions related to coding and documentation criteria and collaborate with compliance on auditing and monitoring activities.
Work collaboratively with other leaders on revenue cycle performance to meet strategic goals and develop guidelines, policies, and procedures through use of data analysis.
Continuously monitor billable revenues to budget, identify and explain significant variances for all revenue streams.
Coordinate and lead regular billing management meetings; conduct detailed review of key performance indicators and trends within accounts receivable for all programs.
Coordinate and lead regular scheduling and registration management meetings; conduct detailed review of key performance indicators and trends for all service lines and locations.
Responsible for department's personnel actions including hiring, training, retention, evaluation, and corrective actions.
Keep abreast of current and future external payer trends and continually evaluate and establish all operational changes necessary to ensure maximization of revenue capture in light of changes in industry reimbursement streams.
Address patient concerns, complaints, discrepancies related to revenue cycle actions which are not resolved at the manager/staff level first.
Ensure strict compliance of HIPAA privacy rules by personnel and that business processes are designed to ensure the confidentiality of patient protected health information.
Manage health center's payer contracts and insurance credentialing, including developing payer contracting strategy, facilitating the negotiation of contract terms and rates, anticipating the impact of contract changes, overseeing communications to payers for contract negotiations and policy clarifications, collaborating with CFO to analyze payment trends, tracking billing/coding metrics, preparing monthly revenue reports, performing regular audits, maintaining knowledge of FQHC revenue cycle management and coding standards, and serving as a subject‑matter expert for documentation standards.
Champion new initiatives, serve as a catalyst for change, and influence others to accept and embrace change.
Perform other duties as assigned.
SKILLS / ABILITIES
Builds and maintains effective relationships with patients, staff, and the public, using strong interpersonal, written, and verbal communication skills to collaborate across departments and with internal and external stakeholders.
Highly organized and detail‑oriented, with strong time‑management skills and the ability to prioritize workload, manage multiple tasks, and consistently meet deadlines with a sense of urgency.
Skilled in developing and executing complex, multi‑faceted project plans while balancing competing priorities.
Proficient in Microsoft Office (Word and Excel required) and experienced with Epic or Epic OCHIN preferred.
Knowledgeable in billing and financial concepts, with the ability to ensure accuracy and efficiency across tasks.
Maintains strict confidentiality when handling sensitive information.
Demonstrates leadership by influencing others, fostering collaboration, and building strong relationships across all levels of the organization.
Demonstrates the ability to work independently and as part of a team, performing effectively under pressure while applying strong analytical thinking, problem‑solving skills, and sound decision-making.
EDUCATION
Bachelor's degree in health‑care administration, business or other related field required.
RELATED WORK EXPERIENCE
Strong, in‑depth knowledge of revenue cycle management principles and practices including medical and dental billing, coding, collections, managed‑care products, regulatory compliance, payor enrollment/credentialing, and financial reporting.
Five years of experience in non‑profit billing and revenue cycle; preferably in an FQHC setting. Minimum of three years managerial/supervisory experience in billing operations.
Knowledge of business management and basic accounting principles to direct the billing and coding office.
Strong background in patient financial management and knowledge of federal and state laws and requirements relating to healthcare management.
PHYSICAL DEMANDS
While performing the duties of this job, the employee is regularly required to sit, talk or hear and has substantial movements of the wrists, hands, and/or fingers.
WORK ENVIRONMENT
The work environment is usually moderate with frequent exposure to significant work pace/pressure.
LINES OF SUPERVISION The Revenue Cycle Director reports to the Chief Financial Officer.
DISCLAIMER: The above statements are intended to describe the general nature and level of work being performed by people assigned to this job class. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.
Community Health Systems, Inc. is an equal opportunity employer.
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Job Title: Revenue Cycle Director Location: Beloit, WI EEO Category: Mid/Senior Mgr Department: Administration Exempt Reports to: Chief Financial Officer Pay Grade: 8
JOB SUMMARY This position is responsible for leading and managing the policies, objectives, and initiatives across all revenue cycle operations for Community Health Systems, Inc. (CHS). The Director will oversee the strategic direction, goal setting, and performance management of the revenue cycle processes, encompassing the best practices related to the use of technology and analytics, as well as practice management processes. The position works closely with Finance and all clinical departments in the coordination of accurate data gathering, proper reimbursement, and prompt and high‑quality patient service. The Director oversees the centralized scheduling, intake, coding, and billing processes for all areas, to ensure that payor requirements are met, and the patient experience is positive.
ESSENTIAL JOB FUNCTIONS
Directs and oversees the overall policies, objectives, and initiatives of the revenue cycle activities to optimize the patient financial interaction with CHS. Specific areas of oversight are centralized scheduling, patient access (registration and benefit navigators), coding, and billing.
Propose and implement policies and procedures, work rules and performance standards to ensure the efficient and effective operation of CHS Revenue Cycle departments in compliance with organizational standards and federal, state and local laws.
Maintain appropriate internal controls over accounts receivables/cash receipts; monitor charge posting, billing, and collection operations for compliance with established policies, regulations, procedures, and standards; and establish benchmarks for “Days in Accounts Receivable” based on Federally Qualified Health Center industry standards.
Design, implement and monitor all key performance indicators to ensure that cash flow is maximized throughout the revenue cycle.
Develop, plan, organize, and implement current and future best practices for revenue cycle scheduling, intake, coding, billing, collections, denial management and other functions.
Continuously identify opportunities for enhancement of revenue capture processes and correct any operational issues that hinder the timely receipt and posting of payments and maximization of cash flow.
Collaborate and coordinate with practice managers and department directors regarding front‑desk operations related to billing, cash management, collections activities and revenue cycle processes.
Consult with Quality / Compliance Department on questions related to coding and documentation criteria and collaborate with compliance on auditing and monitoring activities.
Work collaboratively with other leaders on revenue cycle performance to meet strategic goals and develop guidelines, policies, and procedures through use of data analysis.
Continuously monitor billable revenues to budget, identify and explain significant variances for all revenue streams.
Coordinate and lead regular billing management meetings; conduct detailed review of key performance indicators and trends within accounts receivable for all programs.
Coordinate and lead regular scheduling and registration management meetings; conduct detailed review of key performance indicators and trends for all service lines and locations.
Responsible for department's personnel actions including hiring, training, retention, evaluation, and corrective actions.
Keep abreast of current and future external payer trends and continually evaluate and establish all operational changes necessary to ensure maximization of revenue capture in light of changes in industry reimbursement streams.
Address patient concerns, complaints, discrepancies related to revenue cycle actions which are not resolved at the manager/staff level first.
Ensure strict compliance of HIPAA privacy rules by personnel and that business processes are designed to ensure the confidentiality of patient protected health information.
Manage health center's payer contracts and insurance credentialing, including developing payer contracting strategy, facilitating the negotiation of contract terms and rates, anticipating the impact of contract changes, overseeing communications to payers for contract negotiations and policy clarifications, collaborating with CFO to analyze payment trends, tracking billing/coding metrics, preparing monthly revenue reports, performing regular audits, maintaining knowledge of FQHC revenue cycle management and coding standards, and serving as a subject‑matter expert for documentation standards.
Champion new initiatives, serve as a catalyst for change, and influence others to accept and embrace change.
Perform other duties as assigned.
SKILLS / ABILITIES
Builds and maintains effective relationships with patients, staff, and the public, using strong interpersonal, written, and verbal communication skills to collaborate across departments and with internal and external stakeholders.
Highly organized and detail‑oriented, with strong time‑management skills and the ability to prioritize workload, manage multiple tasks, and consistently meet deadlines with a sense of urgency.
Skilled in developing and executing complex, multi‑faceted project plans while balancing competing priorities.
Proficient in Microsoft Office (Word and Excel required) and experienced with Epic or Epic OCHIN preferred.
Knowledgeable in billing and financial concepts, with the ability to ensure accuracy and efficiency across tasks.
Maintains strict confidentiality when handling sensitive information.
Demonstrates leadership by influencing others, fostering collaboration, and building strong relationships across all levels of the organization.
Demonstrates the ability to work independently and as part of a team, performing effectively under pressure while applying strong analytical thinking, problem‑solving skills, and sound decision-making.
EDUCATION
Bachelor's degree in health‑care administration, business or other related field required.
RELATED WORK EXPERIENCE
Strong, in‑depth knowledge of revenue cycle management principles and practices including medical and dental billing, coding, collections, managed‑care products, regulatory compliance, payor enrollment/credentialing, and financial reporting.
Five years of experience in non‑profit billing and revenue cycle; preferably in an FQHC setting. Minimum of three years managerial/supervisory experience in billing operations.
Knowledge of business management and basic accounting principles to direct the billing and coding office.
Strong background in patient financial management and knowledge of federal and state laws and requirements relating to healthcare management.
PHYSICAL DEMANDS
While performing the duties of this job, the employee is regularly required to sit, talk or hear and has substantial movements of the wrists, hands, and/or fingers.
WORK ENVIRONMENT
The work environment is usually moderate with frequent exposure to significant work pace/pressure.
LINES OF SUPERVISION The Revenue Cycle Director reports to the Chief Financial Officer.
DISCLAIMER: The above statements are intended to describe the general nature and level of work being performed by people assigned to this job class. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.
Community Health Systems, Inc. is an equal opportunity employer.
#J-18808-Ljbffr