Director of Oncology Revenue Cycle Management

About This Role

This role directs oncology revenue cycle teams and collaborates with leadership, partners, and providers to optimize billing practices and maximize revenue opportunities. The Director identifies areas for improvement and implements programs for charge capture, claims, collections, compliance, and other revenue-related processes.

Responsibilities

• Direct all revenue cycle teams and processes across West Cancer Center and affiliated sites
• Ensure accurate charge capture, processing, and reconciliation for oncology services
• Maintain knowledge of and ensure compliance with local, state, and federal regulations
• Collaborate with clinical, operational, and revenue cycle teams to identify revenue enhancement opportunities
• Implement internal compliance audits and assist with external audits; analyze findings and implement safeguards
• Review monthly financial and revenue cycle reports with the Finance team to identify trends and revenue capture opportunities
• Ensure reimbursement aligns with payer contracts and identify opportunities for improvement
• Perform contracting and administrative functions on behalf of West Cancer Center
• Assist with coordination and negotiation of inter-facility and managed care contracts
• Identify opportunities for new managed care relationships and participate in contract review, negotiation, and analysis
• Establish and negotiate pricing for out-of-network and new managed care relationships, including pricing model development
• Assist with education of clinical staff regarding charging practices and follow-up on changes

Requirements

• Bachelor’s degree in finance, business, healthcare, or a related field (or equivalent experience)
• Minimum of five (5) years of progressively responsible healthcare revenue cycle and management experience
• In-depth knowledge of healthcare revenue cycle processes (managed care, pre-certification, charge/claim processing, accounts receivable)
• Knowledge of EDI and clearinghouse requirements
• Strong analytical and reporting skills related to revenue cycle and financial data
• Strong leadership and management skills
• Excellent written, verbal, and group presentation skills
• Proficiency in Microsoft Word, Excel, and Access

Qualifications

• Bachelor’s degree in finance, business, healthcare, or a related field (Master’s preferred)
• Minimum of five (5) years of progressively responsible healthcare revenue cycle and management experience, or six (6) years of leadership/administrative experience in revenue cycle without a Bachelor's degree.

Nice to Have

• Master’s degree in a related field
• Experience in healthcare clinical operations and financial management methods and techniques

Skills

* Required skills

Benefits