The Vice President of Revenue Cycle Management (VP of RCM) is responsible for directing all facets of the organization's revenue cycle operations, encompassing patient intake, insurance eligibility validation, securing treatment authorizations, medical coding, claims submission, payment collection efforts, and appeals processing. This executive-level position is pivotal in devising and enforcing strategies that optimize reimbursement and revenue attainment while rigorously upholding compliance with regulations and requirements mandated by payer entities.
Essential Duties And Responsibilities
- Formulate and execute strategies aimed at optimizing the revenue cycle from the initial patient onboarding stage through the final payment receipt
- Provide overarching leadership and management oversight across all revenue cycle departments, including patient intake, insurance verification, authorization procurement, coding, billing, collections, and appeals processing
- Establish performance metrics, key performance indicators, and reporting mechanisms to monitor revenue cycle operations and pinpoint opportunities for enhancement
- Uphold organizational adherence to payer rules, regulations, and mandates across the entirety of revenue cycle functions
- Maintain comprehensive, expert-level proficiency in insurance plans, coverage policies, authorization criteria, coding guidelines, and reimbursement models specific to ABA services
- Cultivate and manage relationships, as well as negotiate contracts, with payer organizations
- Develop and implement robust denial prevention protocols and appeals management programs
- Leverage data analysis and reporting to identify revenue leakage areas and implement process improvements to rectify gaps
- Recruit, train, coach, and foster the professional development of high-caliber revenue cycle staff
Requirements
Knowledge, Skills, and Abilities
- Comprehensive expert-level knowledge of medical coding, billing regulations, reimbursement models, insurance plans, coverage policies, authorization requirements, and healthcare compliance/regulatory landscape for ABA services
- Proficiency in data analysis, reporting, and leveraging data to identify revenue leakage and drive process improvements
- Strong strategic planning capabilities to develop and implement revenue cycle optimization strategies and denial prevention/appeals management programs
- Excellent communication, presentation, and relationship management skills for working with payer organizations
- Leadership abilities to oversee and manage cross-functional revenue cycle departments, ensure organizational compliance, and drive performance
- Skilled in hiring, training, coaching, and developing high-performing revenue cycle teams
- Expertise in process improvement and operational optimization across the full revenue cycle continuum
Experience And Education
- A bachelor's degree is required, with a master's degree or relevant certification being preferred. In lieu of a degree, fifteen years of RCM work experience will be considered
- 7-10 years of revenue cycle leadership experience required, with experience in the ABA industry strongly preferred
Benefits
- Competitive salary
- Fully remote position
- Generous paid time off and paid holidays
- Medical, dental and vision insurance
- 401k with company match
- On-going support
- Opportunity for career advancement
- We genuinely care about our team members
