Director Revenue Cycle - Front End Operations

Director Revenue Cycle - Front End Operations

Internal Only Department Only

Position Summary: The Director Revenue Cycle – Front End Operations (Patient Access & PreServices) provides strategic and operational leadership for all frontend revenue cycle functions. This role is responsible for ensuring accurate, efficient, and compliant scheduling, preregistration, registration, financial clearance, insurance verification, authorization, and point of service collections. The Director ensures standardized workflows, data integrity, and optimal patient financial engagement to support reimbursement, reduce denials, and improve patient experience. This position collaborates closely with Revenue Cycle leadership, Finance, Compliance, Clinical Operations, IT, and facility leadership.

The Director monitors performance through key metrics, drives process improvement initiatives, and ensures adherence to regulatory requirements and industry best practices.

Responsibilities

• Directs Patient Access and Pre-Service operations, including scheduling, registration, pre-registration, and financial clearance
• Ensures accurate capture of demographic, insurance, and authorization information to support clean claims
• Standardizes workflows across hospital, outpatient, emergency, and physician services
• Coordinates patient flow processes to optimize access and throughput
• Oversees eligibility verification, benefits validation, and prior authorization
• Directs financial counseling, estimates, and price transparency initiatives
• Ensures compliance with Good Faith Estimate requirements
• Leads point of service collection strategies
• Provides leadership for Patient Access workflows within Epic
• Partners with IT and Epic analysts to optimize functionality and reporting
• Supports upgrades and enhancements impacting front-end operations
• Promotes registration accuracy to prevent denials
• Ensures compliance with regulatory and payer requirements
• Maintains audit readiness and compliance w/CMS and applicable HIPAA guidelines for protecting the privacy of patient data
• Monitors registration accuracy, authorization rates, POS collections, clearance rates, wait times, and other KPIs
• Analyzes trends and implements improvements
• Provides regular executive reporting
• Recruits, develops, and retains Patient Access teams
• Establishes productivity standards and expectations
• Promotes service excellence and accountability
• Develops and manages departmental budgets
• Forecasts staffing and operational needs
• Ensures cost-effective delivery of service
• Collaborates with medical staff and clinic leadership on authorization & registration denial root cause remediation
• Provides training & education to clinic staff on payer registration updates and requirements
• Serves as liaison between the Front-End of Revenue Cycle operations and clinical operations
• Performs other related duties as assigned
• Relies on experience and judgment to plan and accomplish goals
• Regular and predictable attendance is an essential job function
• Competent to meet the age‑specific needs of the unit assigned

Requirements and Minimum Qualifications

• Bachelor’s Degree in Healthcare Administration or related field required
• Minimum 5 years’ leadership experience in Patient Access or frontend operations required
• Minimum 15 years’ progressive Revenue Cycle experience preferred
• Experience in an acute care hospital setting is required
• Experience with Epic EHR required
• Strong knowledge of registration, authorization, and financial clearance processes
• Knowledge of CPT and ICD10 concepts as they relate to frontend operations
• Excellent communication and leadership skills
• Demonstrated process improvement capability

Working Conditions

• Must be able to lift and move up to 10lbs
• Must be able to maintain a sitting position
• Typical equipment used in an office job
• Repetitive movements

Kootenai Health complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, veteran status, or sex. Kootenai Health does not exclude people or treat them differently because of race, color, national origin, age, disability, veteran status, or sex.

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