Director of Revenue Cycle Management chez OhioGuidestone

Your Story. Our Mission. A Perfect Match.

OhioGuidestone is the state’s leader in community behavioral health care, serving around 26,000 Ohioans each year. We focus on the needs of the whole person by providing telehealth and in-person prevention services, as well as mental health and substance use treatment. As we help people navigate the most difficult times in their lives—with compassion and respect—we ultimately empower them to take steps towards a healthier future. 

Role: Director, Revenue Cycle Management
Location:  Berea, OH (will not offer relocation. Seeking candidates in Greater Cleveland area only)
Will we sponsor/visa for this role:  No.

Essential Functions

• Directs the growth of all staff with a high emphasis on employee development in the necessary skills to ensure agency success. Demonstrates and models positive leadership, promotes a team based work environment and presents the agency in the most positive light with all internal and external contacts.
• Assures fiscal accountability of all assigned programs and services. This responsibility includes enhancement and maintenance of organizational and cross functional agency processes that impact and are impacted by assigned programming.  Assists in the development of realistic budgets, assisting the Finance Department in assuring that assigned services are adequately documented and that billing requirements are met, working pro-actively to assure budget compliance, and taking immediate action to resolve fiscal problems should they occur. Exhibits and demands care and competence in managing agency resources.

• Assumes a leadership role in the interpretation and support of agency policies (including HR, PR. IT, Compliance, and Communications), implementation of industry best practice standards throughout assigned programs..
• Standardizes revenue cycle process throughout the Agency and across facilities as appropriate
• Continually monitors processes and makes recommendations to improve revenue cycle management, productivity and performance, and executes on agreed upon plans
• Develops and enhances written policies and guidelines, and implements procedures for effectiveness of the revenue cycle management process
• Stays abreast with compliance trends, regulations, and legislation for billing standards/statues
• Creates and implements Dashboard function in Evolv, and manages/reports on information
• Utilizes information in Evolv to make educated strategic recommendations to leadership.
• Establishes and maintains strategic partnership with Clinical and Compliance staff to maximize revenue and minimize bad debt.
• Educates clinical and business office leadership in Federal regulatory requirements relating to clinical conditions for coverage and billing/reimbursement compliance
• Ensures compliance with fiscal contractual and reporting requirements of all Agency contracts/grants
• Monitors and evaluates bad debt reserve levels for appropriateness and make recommendations for adjustments as needed
• Reviews all new and renewal contracts presented to Agency and make recommendations for approval
• Establishes and manages private insurance and MCO relationships relating to the billing/collection functions
• Manages the entire billing process from initial client contact to when a claim has created and paid for
• Monitors and reviews billing, AR, and reconciliations for all revenue sources that the billing team is responsible for. Including reconciles all AR accounts monthly to detail ledgers.
• Identifies areas of risk for services not able to be paid for, and educates clinical staff on these risk areas
• Creates trend reports for compliance to identify areas of risk , and communicates trends to CFO
• Creates and prepares monthly/quarterly/annual reports for revenue, collection and write off trends, and partner with the leadership to address issues and trends
• Builds and manages revenue cycle reports; perform analysis on the, to make process improvements
• Implements and manage collaboration with clinical teams on the prior authorization process for required services
• Manages Agency collection process ensuring proper follow-up and resolution of outstanding balances
• Provides excellent customer services to our clients, and holds reports to same standard of excellence
• Manages credentialing and registration process for new and terminated clients
• Manages the reinstatement process for all Agency clients who’s insurance is reinstated after a lapse of coverage
• Creates KPI’s for the revenue cycle function which will be shared with program directors and make recommendations for improvements
• May be involved in the planning, organization, and implementation of special events, specific projects, or program changes
• Employee may be asked to complete related duties other than those indicated above as assigned by their supervisor

Qualifications

• Required Education BS/BA in Business Administration or related degree.
• Significant experience in A/R Management, collections, analysis and revenue cycle management
• Experience with Behavioral Health Client Billing Software
• Significant experience with the collection of client health records
• Significant knowledge of Medicare, Medicaid, PEIA, and 3^rd Party Insurance Regulations/Compliance/Laws
• Valid driver’s license
• Current proof of auto insurance
• Ability to take and pass a physical exam, tuberculosis test, and drug screening

Performance Requirements

• Must maintain regular and reliable attendance to the satisfaction of management

• Must be able to operate a computer and other position related technologies
• Must be able to verbally exchange information in a confidential manner with employees, clients, students, participants, and/or families in various settings
• Must be available for crisis management by phone as needed
• Must be able to work flexible hours as needed
• Must be able to clearly and confidentially communicate with OhioGuidestone employees, clients, students, participants, and other stakeholders

• Driving may also include transportation of clients, students, or participants

Benefits include:

• • Free CEU trainings
  • Competitive medical benefits including a zero-cost monthly option for employee or employee + children!
  • 10 paid holidays; three are exchangeable
  • Flexible work schedules to support work/life balance
  • Flexible work opportunities to support varying career paths, job roles, intern to hire, and locations
  • 401(k) with employer match option
  • Employment Assistance Program (EAP)
  • Mileage reimbursement
  • Free licensure supervision
  • Recognition and rewards

Physical Requirements

• Must be able to remain in a stationary position 75% of the time
• Must be able to operate a motor vehicle
• Must be able to stoop, stand, walk, bend, and stay upright to perform work
• Must be able to visually read written and digital information
• Must be able to visually determine the accuracy, neatness, and thoroughness of work assigned and/or to make general observations of facilities or structures
• Must be able to receive detailed information through oral communication
• Must be able to hear clients, students, or participants, co-workers, and supervisors at normal speaking levels
• Must be able to dictate with clients, students, participants, co-workers, and supervisors using all means of communication including but not limited to, in-person, phone, and computer
• Must adhere to all Our Promise Values and Guiding Principals

*Funding sources may require OhioGuidestone to hire an advanced degree

At OhioGuidestone we care about the health and safety of our employees. OhioGuidestone requires applicants to complete a pre-employment screening process upon receipt of an offer of employment. We require and cover the cost of a fingerprint background screening, physical, Tuberculosis test, and drug screen after an employment offer is made. Any employment offer is contingent upon receipt of all satisfactory pre-employment screenings.

Committed to creating a more diverse community, we encourage candidates from historically underrepresented groups to apply. EEO/M/F/H/V   #IND1