OverviewPosition Summary: The VP of RCM reports to the SVP of Insuranceer and is responsible for leading the full RCM team, which includes claims submission, overturning denials/rejections, reconciliation bank records with EOB and ensure AR is managed. This role is the primary contact for all 3 rd party insurance initiatives for internal ACI departments and the practices. Manages an internal team of 25+ and outsourced vendors.ResponsibilitiesPosition Duties and Responsibilities :
Manage and lead a team of employees, including developing a high performing team and assessing performance.
Ensure effective and timely contract administration and support.
Ensure KPIs for internal teams output for claims, % received, denials/rejections, and AR
Ensure SLAs for vendors are met and managed.
Monitor all process flows and provide feedback to improve processes and results.
Develop and maintain training modules on plan administration (patient eligibility, claims processing, posting payments, managing AR, outsourcing variations, etc.). Institute and monitor auditing mechanisms to ensure success.
Participate in cross-functional projects as the insurance service expert
Respond to practice team questions regarding RCM and AR.
Develop and maintain revenue cycle metric reports, managing to established benchmarks.
Perform other duties as new opportunities arise and/or as assigned. Demonstrate a strong work ethic, high sense of urgency and the passionate desire to drive results.
QualificationsQualifications
Ability to interpret and effectively communicate all aspects of RCM.
Excellent verbal and written communication skills.
Proven track record for managing RCM functions
Excellent problem-solving skills.
Well organized, accurate, and thorough.
Adaptable; readily adjusts work schedule to adhere to changes in the work environment and is able to manage competing demands.
Adept at prioritizing, planning work activities, and developing reasonable action plans.
Proficiency in all Microsoft Office products.
Education and Experience Requirements:
Bachelor’s degree required.
Minimum 8 to 10 years of RCM management.
Computer Skills:
Proficiency in a Microsoft Windows environment.
Proficiency with dental or medical software.
Core Competencies: To perform the job successfully, an individual should demonstrate the following competencies to perform the essential functions of this position.
Exemplary leadership skills.
High level of customer service orientation.
Ability to assess development needs of affiliated auxiliary practice staff.
Knowledgeable in creating and presenting training course material.
Must possess strong skills in the areas of interpersonal communication, analysis, critical thinking, attention to detail, multi-tasking, and oral & written communication.
Excellent verbal and written communication skills.
Ability to work independently and collaboratively within a team environment.
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