Are you skilled and experienced in Revenue Cycle Management?  Looking for a new challenge in 2024 in a dynamic and innovative environment?  Affect Therapeutics is seeking an experienced and industry savvy Head of Revenue Cycle Management (RCM) to join its Finance and Accounting department.

Affect Therapeutics is a digital addiction treatment provider that connects people seeking support with stimulant, alcohol or cannabis use disorders with licensed counselors for 1:1 and group therapy. Affect also provides contingency management to motivate members to create new positive recovery behaviors and support them through the initial difficult stages of recovery. Affect’s services are offered to our members virtually and our team operates fully remotely.

The Head of RCM shares the Affect Therapeutic values of Empathy, Passion and Accountability and reflects these in their work when managing the operational, financial and programmatic activities for Revenue Cycle, including provider enrollment, credentialing, claims billing, insurance reimbursement and reporting and analytics. This includes establishing, meeting and continuously monitoring RCM goals and objectives while maintaining alignment with the strategic goals and objectives for Affect.  The Head of RCM reports to the CFO and works closely with a variety of stakeholders, coordinating the activities of the revenue cycle process across the company.

 

The Head of RCM is responsible for overseeing the entire revenue cycle process.  This role offers strategic leadership for systems redesign and improvements and/or cost reduction through software enabling and automation. 

Responsibilities include:

  • Payer Contract Activation:
    • Collaborate with Business Development with activation of national and state-specific payer contracts.
    • Maintain relationships with commercial and government payers, including Medicaid and Medicare, to facilitate billing reimbursement.
  • Clinical Credentialing:
    • Develop and implement policies and procedures for the credentialing process.
    • Oversee the initial credentialing and ongoing re-credentialing of healthcare providers or professionals.
    • Ensure compliance with regulatory requirements, accreditation standards, and organizational policies related to credentialing.
    • Implement delegated credentialing function.
    • Implement and optimize technology solutions to enhance the efficiency of the credentialing process.
  • Billing:
    • Oversee the medical billing process and ensure accurate coding and submission to maximize timely and accurate reimbursement.
    • Develop and implement strategies to maximize revenue, reduce denials, and improve collections.
    • Optimize charge capture processes to capture all billable service.
    • Ensure billing practices comply with industry standards and regulations. 
    • Leverage technology solutions to improve billing accuracy, streamline workflows, and enhance reporting capabilities.
  • Collections:
    • Manage AR vendor and make sure they are meeting SLAs and appropriately prioritizing work.
    • Develop KPIs for AR and claims collections.
    • Monitor and analyze collection metrics, identifying areas for improvement and implementing necessary changes internally and externally.
  • Team Leadership:
    • Lead and mentor a high-performing revenue cycle management team.
    • Foster a collaborative and results-driven work environment.
  • Reporting and Analysis:
    • Provide regular reporting on key revenue cycle metrics and financial performance.
    • Conduct in-depth analysis to identify trends, opportunities, and areas for improvement.

Requirements:

  • Bachelor's degree in Healthcare Administration, Business, or a related field; Master's degree preferred.
  • 10+ years of management-level, modern behavioral healthcare experience in revenue cycle with expertise in billing of Medicaid, Medicare and Commercial Managed Care contracts. Healthcare technology experience preferred.
  • Knowledge of various payment models, such as value-based care and Fee-For-Service.
  • Knowledge and understanding of state and federal rules and regulations including laws regarding confidentiality, compliance, release of information, and insurance regulations.
  • Excellent communication and interpersonal skills.
  • Ability to demonstrate a commitment to quality and excellence.
  • Exceptional analytical and problem solving skills.
  • Systems thinker.
  • Committed to a high ethical standard in everything you do.
  • Familiarity with EMRs, Practice Management solutions, Metabase (or other BI tools), Google Suite, and Slack.

We are unable to sponsor H1-B Visas at this time.  Please do not apply if you are not within US time zones.

 

If you are passionate about making a difference in the lives of individuals with substance use disorders, possess the qualifications outlined above, and want to be part of a forward-thinking organization that values passion, empathy, and accountability, we encourage you to apply for the Head of RCM position at Affect Therapeutics. Join our team and contribute to our mission of providing virtual treatment and support to those in need.

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