RCO Payer Perform Nat'l Direct

Job Description

Job Description

Responsibilities

Artificial Intelligence; Advanced Technology; The very best in patient care. With decades of expertise, RadNet is Leading Radiology Forward . With dynamic cross-training and advancement opportunities in a team-focused environment, the core of RadNet’s success is its people with the commitment to a better healthcare experience. When you join RadNet as our RCO Payer Performance National Director , you will be joining a dedicated team of professionals who deliver quality, value, and access in the 21st century and align all stakeholders- patients, providers, payors, and regulators achieve the best clinical outcomes.

JOB SUMMARY

The RCO Payer Performance National Director (PPND) is responsible for understanding and executing day-to-day processes of the payers as they relate to revenue cycle functions, building and maintaining relationships with operational leaders, support team members and payer contacts at every level. The PPND will work strategically, proactively and collaboratively to align revenue cycle, clinical operations, managed care and credentialing to ensure transparency on the payer’s performance.

You will:

• Work with various functional areas within RadNet to provide feedback on key AR performance indicators, an understanding of current AR, and where we are in identifying gaps in our efforts to maintain all established metrics.
• Speak to, address, through resolution revenue cycle performance deficiencies by payer.
• Provide analytical analysis and create written executive summary updates/briefs of all work and be expected to present these findings to Executive leadership.
• Responsible for the wind-down process when locations/practices close or transitioning to another TIN.
  • Within this process facilitate payer projects for AR that needs special attention.
  • Work with the management that supports the day-to-day, and/or Projects team to ensure proper resources are delegated to these specific accounts.
  • Partner to outline and maintain updates for leadership on expected date of completion so that bank accounts can be closed and outstanding patient AR can transition to collections.
• Monitors effectiveness of collection efforts and maintains insurance billing tools within the RCO Repository remains current within the established time frame (seventy-two (72) hours of awareness).
• Compiles and prepares various status reports for performance analysts in order to identify trends and make recommendations.

• Provides projections and reports as required, for development and management of budget; produce and analyze monthly reports that assist in the monthly forecast processes.
• Work with Practice Performance Team ensuring we understand outward-facing customer-centric opportunities to develop the strategies and tactics that positions RadNet to maximize timely collections.
• All communications and relevant information pertaining to the Payer is disseminated to the respective Teams Leaders {Ops, Credentialing, Contracting, IVT, Systems, etc.}
• SME in revenue cycle management including monthly reporting, identifying issues affecting performance and recommended actions to drive success.

If You Are:

• Bachelor’s degree in healthcare administration, business management or closely related field is strongly preferred Or at least five years of radiology industry experience.
• Three to five years’ experience in healthcare, preferable Billing/Reimbursement Operations setting, or in a Managed Care Contract Administration/contract negotiations setting.
• Strong presentation skills and track records presenting to Boards, C-level executives.
• Strong analytical skills and adept in interpreting strategic vision into an operational model.

• Experience communicating at all levels in the organization, with strong oral, written skills.
• Ability to work independently.
• Demonstrated ability to multi task, manage multiple projects and customers.
• Strong financial acumen and a metric/measurement orientation are required.
• Extensive knowledge with billing applications such as databases, off the shelf billing software, radiology information systems and general intermediate skills utilizing Access and/or Excel.
• Previous management/leadership experience required.

Ideal Candidate will possess:

• Attends and organizes regular corporate and interdepartmental meetings as requested and/or required.
• Communicates, cooperates, and consistently functions professionally and harmoniously with all levels of supervision, co-workers, patients, visitors, and vendors.
• Demonstrates initiative, personal awareness, professionalism and integrity, and exercise confidentiality in all areas of performance.
• Follows all local, state and federal laws concerning employment to include but not limited to: I-9, Harassment, EEOC, Civil rights and ADA.
• Follows OSHA regulations, RadNet and site protocols, policies and procedures.
• Follows HIPAA, compliance, privacy, safety and confidentiality standards at all times.
• but not limited to: I-9, Harassment, EEOC, Civil rights and ADA.
• Follows OSHA regulations, RadNet and site protocols, policies and procedures.
• Follows HIPAA, compliance, privacy, safety and confidentiality standards at all times.

Pay Range: $130,000 - $145,000 per year