The Centers

Job Summary

The Director of Revenue Cycle is responsible for overseeing the revenue cycle management process. This position is responsible for independently performing essential activities related to revenue billing, collections, and managing accounts pertaining to patient accounts receivable.

Essential Job Duties & Responsibilities

• Lead and manage the revenue cycle operations to ensure efficient billing and collection processes.
• Monitor and analyze financial performance metrics related to revenue generation and accounts receivable.
• Collaborate with cross-functional teams to develop strategies that enhance revenue stream and reduce outstanding accounts.
• Ensure compliance with regulatory requirements and industry standards in billing practices.
• Identify areas for process improvement and implement best practices to optimize revenue flow.
• Provide development, training and guidance to staff including assignment of workloads.
• Resolves issues, verify procedures, identify areas of concern and follows up on department’s performance.
• Prepare and present financial reports to stakeholders, highlighting trends and recommendations for improvement.
• Manages, in conjunction with external billing vendor, continued billing to Medicare, Medicaid Managed Care, Ohio Department of Medicaid, Self-Pay and Commercial payers.
• Ensure that claims denied from Medicaid, Medicare, and commercial payers are being resolved.
• Serves as liaison between third-party billing companies, Human Resources and providers with respect to enrollment and credentialing for Medicare, Commercial Insurance and Medicaid eligible staff.
• Maintains understanding of the registration process within EPIC Electronic Health Record and collaborates to ensure accuracy.
• Manages navigation of the Provider Network Management portal for Ohio Medicaid.
• Manages review of Remittance Advices and Explanation of Benefits for accuracy and works to resolve discrepancies.
• Manages and ensures proper posting of payments by third-party billing company and reconciles with cash payments received by organization.
• Manages and ensures third-party billing company has registration and clinical information needed to facilitate the working of denied claims and collection activities.
• Manages tracking service authorizations and pre-certifications and works with enrollment staff to ensure proper approvals have been requested.
• Manages monitoring of state remittance reports.
• Manages bank deposit and remittance transactions and processing and cash posting.
• Manages performance of follow-up on outstanding invoices and discrepancies.
• Develop and refine written processes for all responsibilities.

Other Job Duties & Responsibilities

• Attends training seminars, monitors the websites for the various funding sources to keep apprised of current information, and will make suggestions for implementation.
• Other duties as assigned

Supervisory

• Directly manages billing and accounts receivable staff.

Job Qualifications

• Bachelor’s degree preferred. In lieu of a degree, eight years or more of relevant experience.
• Three to five years of experience in revenue cycle management, billing, and collections within a healthcare setting.
• Previous demonstrated experience in effectively supervising and leading a diverse team.
• Strong analytical skills with the ability to interpret financial data and make strategic decisions.
• Experience with credentialing for Medicare, Insurance and Medicaid.
• Experience with various payer portals and vendor clearinghouses.
• Knowledge of government billing guidelines and compliance regulations for commercial insurance, Medicare and Medicaid.
• Knowledge of CPT and ICD codes.
• Experience using practice management billing systems/software and Epic a plus
• Advance knowledge of Microsoft Word, Microsoft Excel and billing software programs.

Core Competencies

• Analytical Thinking: able to identify and define opportunities for improvement, extract key information from data and develop workable solutions for the problems identified in order to test and verify the cause of the problem and develop solutions to resolve the problems identified; uses logical reasoning to break down and work through a situation or problem to arrive at an outcome; sees patterns and trends in the data and draws meaningful conclusions from it.
• Continuous Improvement: Ensures work meets or exceeds standards and identifies and implements ways to make job tasks or processes more efficient.
• Influence: Uses persuasion to gain the support and cooperation from stakeholders, superiors, colleagues, subordinates, and other parties to achieve a desired course of action consistent with the organization’s strategic goals and objectives.
• Situational Leader: Ability to adjust leadership style to meet the readiness level of each team member. enables and empowers team members to develop their competency and commitment in completing goals and tasks; creates an environment of trust and mutual respect and sets an example for other leaders in the organization.
• Accountability: Holds self and others accountable for measurable, high-quality, timely, and cost-effective results. Determines objectives, sets priorities, and delegates work. Accepts responsibility for mistakes. Comply with established control systems and rules.
• Managing Vision and Purpose: Communicates a compelling and inspired vision or sense of core purpose; talks beyond today; creates mileposts and symbols to rally support behind a vision; makes the vision sharable by everyone; can inspire and motivate entire units or organizations.
• Values Diversity: Values all people for their unique talents and diverse viewpoints. Actively encourages practices that support diversity, inclusion, and cultural competence. Collaborate with and involves others, interacts well with diverse people and groups, thereby contributing to an environment that is equitable, inclusive, and cooperative. Shows an awareness of and sensitivity to the cultural diversity of the population served.

Physical Demands/Work Environment

This job operates in a professional office environment. This role routinely uses standard office equipment. While performing the duties of this job, the employee is regularly required to speak and hear. The employee is frequently required to sit for extended periods of time, stand, walk, use hands and fingers, and reach with hands and arms. It requires the ability to lift files, open filing cabinets and bend or stand on a stool as necessary. Travel and work outside of normal hours may be required for meetings, presentations, trainings, and other events.

This job description is not intended to be a complete list of all responsibilities, duties or skills required for the job and is subject to review and change at any time, with or without notice, in accordance with the needs of The Centers. Since no position description can detail all the duties and responsibilities that may be required from time to time in the performance of a job, duties and responsibilities that may be inherent in a job, reasonably required for its performance, or required due to the changing nature of the job shall also be considered part of the jobholder's responsibility.

Why Join Us?

You’ll be part of a mission-driven organization that values growth, collaboration, and people. We offer a supportive environment where your ideas and leadership will directly impact our culture and the professional development of our team.

The Centers, through healing, teaching, and inspiring, provides individuals and families in Greater Cleveland the opportunity to reach their full potential. As a comprehensive social service and healthcare organization, The Centers operates at 11 locations. The Centers served over 20,000 individuals in 2024 through its four core service areas: Integrated Health & Wellness; Early Learning & Family Support; Workforce Development; and, Residential Youth Programs.

We offer a comprehensive and competitive benefits package which includes a choice of health plans, contribution to your retirement savings, life, short and long term disability and more.