DescriptionJOB SUMMARY
The Director of Revenue Cycle is a new role and will be responsible for developing and managing all aspects of revenue cycle operations, particularly the integration of Medicaid billing and managed care organization (MCO) processes. This is a high-impact position ideal for someone who is detail-oriented, strategic, and committed to improving the financial sustainability of a community-focused organization.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Revenue Cycle Strategy & Leadership
- Develop and implement a comprehensive revenue cycle management strategy.
- Establish protocols to ensure accurate and timely billing and collections.
- Monitor revenue performance and report financial trends to leadership.
Managed Care Organization (MCO) Oversight
- Review MCO contracts for included services and billing guidelines.
- Coordinate with MCOs to stay current on policy changes and reimbursement procedures.
Medicaid Implementation & Billing
- Develop a Medicaid billing process tailored to the organization’s services.
- Create and manage a Medicaid billing tracker.
- Ensure documentation aligns with Medicaid billing requirements.
Billing Operations
- Supervise Billing Specialist
- Submit and manage claims through MCO billing portals.
- Review resident assessments to ensure proper documentation.
- Analyze billing denials and resubmit corrected claims.
Credentialing & System Navigation
- Assist with staff credentialing in NC Tracks.
- Maintain current provider enrollment and avoid service interruptions.
Process Improvement & Compliance
- Streamline documentation and billing workflows.
- Ensure compliance with all Medicaid and MCO regulations.
- Provide training to staff on billing protocols.
- Ensure compliance with agency policies, procedures, and standards, upholding the organization’s mission and values
QualificationsPOSITION QUALIFICATIONS:
- Bachelor’s degree in healthcare administration, finance, or related field (Master’s preferred).
- Minimum of 5 years in healthcare revenue cycle management, including Medicaid billing.
- Knowledge of NC Medicaid and MCO billing systems.
- Experience in behavioral health or substance use disorder treatment preferred.
- Proficiency in electronic billing systems and payer portals.
- Strong analytical and organizational skills.
- Ability to communicate clearly and train interdisciplinary teams.
PHYSICAL REQUIREMENTS:
- Keyboarding
- Walking/Sitting
- Lifting
