Director, Revenue Cycle-Patient Accounting bei Yale Campus - Hospital

Job Summary: The Director, Revenue Cycle-Patient Accounting is responsible for directing and coordinating all aspects of patient financial services including professional and hospital claims billing, cash posting, and management of patient receivables. This role ensures timely, compliant, and accurate billing and collections processes to optimize revenue while improving patient and customer satisfaction. The Director provides strategic leadership and day-to-day operational oversight to maximize cash flow, reduce accounts receivable days, and ensure effective claims adjudication. This position plays a key role in monitoring pertinent revenue cycle metrics, including charge lag, denial rates, days in Accounts Receivable, and cash collections. The Director also collaborates with leadership and physicians to develop and implement best practices in patient accounting, while ensuring compliance with all federal, state, and contractual requirements.

Minimum Education: Bachelor’s degree in Business, Healthcare, or related field.

Licensure, Registration and/or Certification: None.

Work Experience: Minimum 8 years experience in Hospital and Professional billing and claims in an Epic environment. Experience with Epic systems.

Knowledge, Skills, and Abilities: Extensive knowledge of healthcare revenue cycle management, particularly in patient accounting. Advanced knowledge of Microsoft 365 and other applicable software applications. Strong leadership and team management skills, with a focus on improving efficiency and patient satisfaction. Sound organizational skills to manage multiple tasks and deadlines effectively with the ability to identify and resolve problems efficiently. Strong ability to develop and execute strategies that improve billing and Accounts Receivable management. Ability to manage and optimize claims workflows, with using Electronic Medical Record (EMR) and Electronic Health Record (EHR) systems. Effective ability to work in a collaborative team environment and build strong relationships with team members.

Essential Functions and Responsibilities: Directs daily operations of patient accounting including Epic-based billing, follow-up, payment posting, and Accounts Receivable resolution for both professional and hospital services. Ensures accurate and timely claim submission and remittance processing using Epic Resolute Hospital Billing/Professional Billing (HB/PB) and associated claims tools (e.g., Claim Edit Work Queues (WQs), Remittance Processing, and Correspondence WQs). Manages automation tools such as Epic Clearinghouse Integration, Batch Posting, and Auto-Posting configurations. Manages and mentors a team of managers and supervisors, ensuring effective use of Epic workflows and task lists. Coordinates Epic training for patient accounting staff and promotes adherence to Epic best practices and new functionality rollouts. Oversees training and competency development related to Epic front-end collections and patient communications via MyChart and other digital tools. Monitors and reports on Epic-based Key Performance Indicators (KPIs) such as Days in Accounts Receivable, Clean Claim Rate, First Pass Resolution Rate, and Denial Trending. Uses Epic dashboards and workbench reports to proactively identify issues and lead performance improvement efforts. Collaborates with Epic Application Support, IT, Revenue Integrity, and clinical departments to resolve issues affecting billing and collections. Participates in Epic upgrade testing, revenue cycle optimization projects, and system-wide Epic governance committees as needed. Identifies opportunities for automation and improved integration between Epic and external vendors (e.g., collections, lockbox, payment portals). Ensures Epic workflows meet payer billing requirements and comply with Center for Medicare and Medicaid Services (CMS) and state guidelines. Works with Compliance and Internal Audit to monitor Epic workflows for proper controls, segregation of duties, and documentation. Prepares and manages the patient accounting departmental budget; tracks Epic-related technology costs and identifies Return On Investment (ROI) opportunities.

Decision Making: Independent judgment in making decisions from many diversified alternatives that are subject to general review in final stages only.

Working Relationships: Direct supervision of others. Prepares and gives performance evaluations. Works directly with patients and/or customers. Works with internal and/or external customers via telephone or face to face interaction. Works with other healthcare professionals and staff. Works frequently with individuals at Director level or above.

Special Job Dimensions: None.

Supplemental Information: This document generally describes the essential functions of the job and the physical demands required to perform the job. This compilation of essential functions and physical demands is not all inclusive nor does it prohibit the assignment of additional duties.

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