BrightSpring Health Services

The Sr. Director is responsible for management of the Revenue Cycle organization and process to ensure the timely and accurate billing of services provided and maximizing collections on all billings for the rehabilitation business unit. The Sr Director's responsibilities include identifying reimbursement issues, ensuring that claims, denials, and appeals are efficiently processed, and resolving billing-related issues. This position will work in collaboration with Contracting, Field Branch Operations, Credentialing, and central functions at Support Center including Cash Control and Accounting. They should be able to lead strategic initiatives, utilize technologies, and create an environment of continual improvement to improve the efficiency of revenue cycle processes and overall financial performance.

• Manage all aspects of the revenue cycle including but not limited to billing, collections, cash posting, contract analysis, communications with insurance providers, and account management. Perform all end of month closing procedures.
• Develop sustainable processes to bill and adjudicate claims timely to maintain a benchmark cash goal.
• Develop denial management processes to eliminate denial root causes and reduce the denial impact on the organization. Collaborate with clinical departments to resolve and expedite solutions.
• Partner with contracting and operations teams to evaluate collection capabilities and adherence to payer contracts.
• Ensure maximization of cash collections through diligent and timely monitoring of all open accounts receivable balances.
• Establish key metrics and performance indicators aligned with Provider Revenue goals; analyze operating results and take adequate steps to correct shortfalls in quality and collections performance.
• Manage individual(s) including, but not limited to, hiring, training, work assignments, manage and evaluate performance, and conduct professional development plans. Ensure that the productivity and actions of the managed group meet and support the quality goals.
• Determine teams training requirements and ensure that timely and effective training is performed to enhance the skill base of the team.
• Adhere to all policies and procedures, within the most stringent attention to complying with all governmental and HIPAA mandated patient protections.
• Account for internal control responsibilities in line with the organization’s objectives.
• Investigate and resolve complex RCM problems and coordinate efforts to provide innovative strategies and solutions.
• Stay abreast of payer requirements and changes in the industry and communicate those changes to team and leadership.
• Assess and respond to current and future internal and external healthcare trends to establish and ensure the necessary direction for revenue cycle activities.

 

• Requires a bachelor's degree of accounting, finance or Business Management or related field of study. Master's degree in business or finance is preferred.
• 10+ years of progressive management experience.
• At least 8 years of experience managing Professional Billing / Revenue Cycle Management and/or Collections in a large healthcare provider setting or a Medical Claims Processing organization.
• Proven experience in successfully leading revenue cycle teams (larger than 20 employees) and implementing strategic initiatives to optimize financial performance and maximize cash collection.
• Experience in designing and executing workflows to operationalize best practice strategies for payments/collections.
• Extensive knowledge of government and payer billing regulations and payer requirements.
• Understanding of third-party payer contracting language and reimbursement terms.
• Experiences with multiple billing and eMR systems.
• Solid grasp of medical terminology, ICD9/10, CPT, and HCPC coding.
• Specific experience in a rehabilitation setting is preferred.
• Strong organizational, time management, and analytical skills
• Possesses the versatility required to be a leader, manager, teacher, coach, and mentor while placing high value on people and process.
• Demonstrated proficiency in Microsoft Office Suite (Power Point, Word and Excel) at the intermediate to advanced level.
• Excellent communication and interpersonal skills to collaborate with internal stakeholders, including CFO, finance teams, and senior executives, as well as external partners such as payers and vendors.
• Ability to drive change, manage multiple complex projects, and deliver measurable results.
• Must be able to assess situations, identify issues/problems and prioritize duties.
• High ability to thrive in a fast-paced, highly dynamic environment and leverage available data to be decisive in unstructured environments.
• Travel 25-50% to regional Business Centers and Support Center

BrightSpring Health Services provides complementary home- and community-based pharmacy and provider health solutions for complex populations in need of specialized and/or chronic care. Through the Company’s service lines, including pharmacy, home health care and primary care, and rehabilitation and behavioral health, we provide comprehensive and more integrated care and clinical solutions in all 50 states to over 450,000 customers, clients and patients daily. BrightSpring has consistently demonstrated strong and often industry-leading quality metrics across its services lines while improving the quality of life and health for high-need individuals and reducing overall costs to the healthcare system. For more information, please visit www.brightspringhealth.com. Follow us on Facebook, LinkedIn, and X.