Posted 20 days ago
Director, Revenue Cycle Operations
RemoteRemote
AI Summary
Directs Revenue Cycle Operations for a hospital, overseeing billing, claims processing, accounts receivable, denial management, and patient financial services. Leads workflow improvement, staff training, and vendor oversight while ensuring compliance with Medicare, Medicaid, and commercial payer requirements.
About this role
Vail Health has become the world’s most advanced mountain healthcare system. Vail Health consists of an updated 520,000-square-foot, 56-bed hospital. This state-of-the-art facility provides exceptional care to all of our patients, with the most beautiful views in the area, located centrally in Vail. Learn more about Vail Health here.
Some roles may be based outside of our Colorado office (remote-only positions). Roles based outside of our primary office can sit in any of the following states: AZ, CO, CT, FL, GA, ID, IL, KS, MA, MD, MI, NC, NJ, OH, OR, PA, SC, TN, TX, UT, VA, WA, and WI. Please only apply if you are able to live and work primarily in one of the states listed above. State locations and specifics are subject to change as our hiring requirements shift.
About the opportunity:
Coordinate and lead the activities of Revenue Cycle Operations, including hospital billing, cash posting, claims processing, accounts receivable follow up, denial management, credit balance resolution, reimbursement, vendor oversight, and related patient financial services. Create, maintain, and administer training, workflow standardization, and professional development programs to increase staff knowledge, operational consistency, regulatory compliance, and performance against revenue cycle goals.
What you will do:
- Identify, implement, and continuously improve revenue cycle and patient account processes across hospital billing, claims management, cash posting, accounts receivable, denial prevention and recovery, revenue recovery, and related workflows.
- Integrate revenue cycle processes into hospital systems workflows, including Epic Resolute Hospital Billing, claims, remittance, work queues, charge review, claim edits, denial trending, and productivity monitoring.
- Analyze and track volume indicators, financial performance, and operational key performance indicators, including days in accounts receivable, aged accounts receivable, collections, clean claim rate, denial rate, denial recovery, discharged-not-final-billed or discharged-not-submitted activity, productivity, and quality metrics.
- Maintain thorough knowledge of Medicare, Medicaid, governmental, managed care, and commercial reimbursement methodologies, payer requirements, and contracts; ensure compliance by the organization and third-party payors as applicable.
- Improve the patient financial experience by supporting clear, compassionate, and accessible billing and financial services communication, including financial assistance, patient satisfaction opportunities, and point-of-service collection practices where applicable.
- Oversee selection, training, supervision, performance management, cross-training, and succession planning for the Patient Financial Services team in accordance with approved staffing plans, budgets, and organizational policies.
- Develop operating and capital budgets for the department and operate within approved financial parameters; protect organizational assets by monitoring cash, adjustments, credit balances, reconciliation activity, vendor performance, and applicable controls.
- Provide oversight of outsourced revenue cycle vendors and strategic business partners, including service level expectations, productivity and quality benchmarks, performance review, scorecards, return on investment, and corrective action planning.
- Role model the principles of a Just Culture and Organizational Values.
- Must be HIPAA compliant.
This description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.
What you will need:
Experience:
- 7 or more years of supervisory experience in a health care setting is required
- Progressive revenue cycle leadership experience within an acute care hospital or integrated delivery system is preferred.
- Demonstrated experience managing or overseeing patient accounts, billing, accounts receivable follow up, denials, cash posting, claims processing, revenue recovery, vendor relationships, and operational improvement initiatives is preferred.
- Working knowledge of Medicare, Medicaid, Government, managed care, and Commercial Insurance filing regulations and reimbursement methodologies is required.
- Experience with Epic revenue cycle workflows, including Resolute Hospital Billing, claims, remittance, work queues, reporting, or post-implementation optimization is required.
License(s) and Certification(s):
- Epic Resolute Hospital Billing, Epic Revenue Cycle Administration, Epic Cogito, or HFMA certification preferred.
Benefits at Vail Health (Full Time) Include:
- Competitive Wages & Family Benefits:
- Competitive wages
- Parental leave (4 weeks paid)
- Housing programs
- Childcare reimbursement
- Comprehensive Health Benefits:
- Medical
- Dental
- Vision
- Educational Programs:
- Tuition Assistance
- Existing Student Loan Repayment
- Specialty Certification Reimbursement
- Annual Supplemental Educational Funds
- Paid Time Off:
- Up to five weeks in your first year of employment and continues to grow each year.
- Retirement & Supplemental Insurance:
- 403(b) Retirement plan with immediate matching
- Life insurance
- Short and long-term disability
- Recreation Benefits, Wellness & More:
- Up to $1,000 annual wellbeing reimbursement
- Recreation discounts
- Pet insurance
The posted salary range for this position is the anticipated hiring range in Colorado and will be adjusted based on geographic location. Vail Health considers a variety of factors in making compensation decisions which influence the offer a candidate receives.
Yearly pay:
$102,398—$146,265 USD
Skills
Accounts ReceivableBudget ManagementCash PostingClaims ProcessingCommercial InsuranceDenial ManagementEpic CogitoEpic Resolute Hospital BillingEpic Revenue Cycle AdministrationHFMAHIPAAManaged CareMedicaidMedicarePerformance ScorecardsRevenue RecoveryService Level AgreementsVendor OversightWorkflow Standardization
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