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Somatus Director, Revenue Cycle Management in Boston, Massachusetts

Director, Revenue Cycle Management at Somatus

Remote

Description:

The Director, RCM, under direction of the VP, MSO, is responsible for overseeing the strategic execution and performance of end-to-end revenue cycle functions and optimization of RCM metrics.

Essential Duties & Responsibilities:

  • Optimization of revenue cycle information systems.

  • Responsible for developing and implementing policies, procedures and processes related to revenue cycle functions.

  • Drive key performance metrics and hold teams accountable. Manage metrics and goals related to finance, revenue cycle, implementation, and productivity.

  • Develop a consistent and coordinated billing model that drives financial performance within an evolving landscape.

  • Responsible for successful management of the following areas of Revenue Cycle Management: Refund processing, revenue Optimization, AR Management, Training, Unpostables, Refunds, Coding and Overpayments.

  • Evaluate workflows, processes and optimization efforts and implement process improvements.

  • Analyze performance against established internal and national best practice benchmarks.

  • Assess potential new physician practices through a rapid RCM consulting-like engagement. Establishes optimal staffing ratio and services to be provided if partnership ensues.

  • Provide advice, support and solutions regarding matters related to all aspects of revenue management.

  • Subject matter expert on payer reimbursement, accurate claim processing, claim submission, collections, and other general revenue cycle management.

  • Monitors regulatory and health plan audit results to ensure compliance.

  • Lead and attract top talent, motivate, assess, train, and manage performance to achieve highest and best use of talent.

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Qualifications:

Required

  • Bachelor’s degree in Business Administration, Healthcare Management or other industry-related field. MBA, or Masters-Degree is preferred in healthcare, or other related fields of study.

  • Seven (7) years of industry-related experience including four (4) in senior leadership position.

  • Leadership experience of people, programs, and resources.

Knowledge, Skills, & Abilities

  • Analytical capabilities to compile and prepare reports.

  • Work independently while completing billing and continual follow up on routine and challenging accounts.

  • Ability to work in multiple billing, insurance verification, and precertification systems simultaneously.

  • Ability to problem solve, analyze high dollar claims/cycles, and solve complex account resolutions.

  • Excellent interpersonal, verbal, and written communications skills.

PHYSICAL REQUIREMENTS:

  • This job operates in a professional office setting. While performing the duties of this job, the employee is regularly required to sit or stand for extended periods of time. Normal manual dexterity is required.

  • Normal speaking and hearing abilities to interact with others in an office environment, over telephone or other video conferencing platform.

  • The employee is occasionally required to stand; walk; and reach with hands and arms and continuously repeat the same hand, arm finger motion many times as in typing. 

OTHER DUTIES:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Our priority is the health and safety of our members, colleagues, partners, and community. Proof of COVID-19 Vaccination is required for employment. If you are unable to be vaccinated for medical reasons or sincerely-held religious beliefs, we will consider requests for reasonable accommodations consistent with our policy, and where we are able to provide such accommodations without undue hardship to the company pursuant to applicable law.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions .

Somatus, Inc. provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law. Further, the company takes affirmative action to ensure that applicants are employed, and employees are treated during employment without regard to any of these characteristics. Discrimination of any type will not be tolerated.

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