Talent.com
Director of Revenue Cycle
Director of Revenue CycleAPLA Health • Los Angeles, CA, US
Director of Revenue Cycle

Director of Revenue Cycle

APLA Health • Los Angeles, CA, US
[job_card.30_days_ago]
[job_preview.job_type]
  • [job_card.full_time]
[job_card.job_description]

APLA Health provides quality healthcare, life-saving services, camaraderie, compassion, and comfort to all who come through our doors. Our dedicated team of healthcare professionals is committed to providing personalized and compassionate free and low-cost medical services, tailored specifically to meet the unique needs of each individual we serve. APLA Health serves as a medical home providing an array of integrated healthcare services through 71,000+ billable patient visits and nearly 10,000 enabling services visits each year. Services provided include : medical, dental, behavioral health and HIV care; pharmacy; PrEP counseling and management; health education and HIV prevention; and STD screening and treatment. For people living with HIV, APLA Health offers housing support; benefits counseling; home healthcare; and the Vance North Necessities of Life Program food pantries; among several other critical support services.

We offer great benefits, competitive pay, and great working environment!

We offer :

  • Medical Insurance
  • Dental Insurance (no cost for employee)
  • Vision Insurance (no cost for employee)
  • Long Term Disability
  • Group Term Life and AD&D Insurance
  • Employee Assistance Program
  • Flexible Spending Accounts
  • 11 Paid Holidays
  • 4 Personal Days
  • 10 Vacation Days
  • 12 Sick Days
  • Metro reimbursement or free parking
  • Employer Matched (6%) 403b Retirement Plan

This is a great opportunity to make a difference!

This position will pay $128,263.87 - $173,895.43 annually. Salary is commensurate with experience.

POSITION SUMMARY :

Under the direction of the Chief Financial Officer, the Director of Revenue Cycle manages front-end patient registration, coding, billing, and collections to maximize reimbursement and ensure compliance, particularly with Medicaid and Medicare Prospective Payment Systems (PPS). Key responsibilities include overseeing claims processing, minimizing denials, managing payer contracts and relationships, ensuring regulatory compliance, and providing strategic leadership for the entire revenue cycle. The role requires strong leadership, analytical skills, and expertise in FQHC-specific (Federally Qualified Health Center) billing and coding requirements. This position supervises the Revenue Cycle Manager and the Enrollment and Eligibility Manager.

ESSENTIAL DUTIES AND RESPONSIBILITIES :

  • Provide overall direction for APLA Health’s revenue cycle operations.
  • Develop, implement and oversee effective billing and collections procedures
  • Oversee all aspects of patient enrollment, insurance verification, coding, billing, claims processing, and payment posting.
  • Ensure adherence to all FQHC-specific federal, state, and payer regulations, including HRSA guidelines.
  • Ensure sliding fees are followed and calculated annually (posted and internal EHR system).
  • Manage the configuration of all electronic billing systems to ensure proper functioning for effective and efficient billing and collection processes.
  • Maintain fee schedules.
  • Develop, implement and oversee procedures to ensure coding accuracy.
  • Ensure timely monthly close.
  • Prepare and distribute end-of-the-month management reports
  • Provide support and training to practitioners to ensure accurate and timely filing of claims.
  • Analyze claims data and implement procedures to maximize HEDIS and incentive revenue collections (i.e., level II HCPCS codes, ICD-10 and CPT modifiers).
  • Track and report metrics related to the patient engagement cycle including recording coding error rates and billing turnaround times to develop sound revenue cycle analysis and reporting.
  • Maintain and manage all applicable registrations and periodic reporting for CMS (Medicare and Medicaid).
  • Assist in preparing, validating and submitting Revenue Cycle information for the Medicare Cost Reports
  • Work closely with the Chief Medical Officer, Chief Nursing Officer, Chief Clinical Operations Officer, Chief Dental Officer, and Chief Behavioral Health Officer to coordinate patient billing and payment requirements.
  • Balance and reconcile bank deposits for Patient Accounts Receivable.
  • Works with the CFO to develop processes and procedures for the efficient and successful flow of information between the billing department and clinical departments.
  • Executes upon key strategies and performance indicators to drive the collection of earned reimbursement.
  • Implement and maintain policies and procedures to ensure the proper investigation and resolution of denied or rejected claims.
  • Oversee the submission and reconciliation of Medicare and Medicaid claims and PPS cost reports to secure accurate reimbursement.
  • Implement strategies to reduce claim denials and manage the appeals process to recover lost revenue.
  • Manage relationships with third-party billing vendors and negotiate and manage contracts with insurance payers.
  • Track and report on key performance indicators (KPIs) such as days in accounts receivable, denial rates, and clean claim rates to drive improvements.
  • Lead, mentor, and train revenue cycle staff and enrollment staff to ensure efficient and compliant operations.
  • Drive continuous improvement initiatives to optimize workflows, systems, and financial performance.

    • OTHER DUTIES MAY BE ASSIGNED TO MEET BUSINESS NEEDS.

    [job_alerts.create_a_job]

    Director Revenue Cycle • Los Angeles, CA, US

    [internal_linking.related_jobs]
    Senior Director of Sales - West Coast

    Senior Director of Sales - West Coast

    Diversified • Burbank, CA, United States
    [job_card.full_time]
    Diversified is a global leader in audio visual and media innovation, recognized for designing and building the world's most experiential environments. Our award-winning team specializes in deliverin...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Assistant Director, Catering & Events

    Assistant Director, Catering & Events

    The Fairmont Hotel • Long Beach, CA, United States
    [job_card.full_time]
    Fairmont Breakers is a beloved feature of the Long Beach skyline, a historic landmark with a character and soul of its own. Originally opened in the roaring twenties as a lavish hotel on the waterfr...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Vice President of Revenue Cycle

    Vice President of Revenue Cycle

    Beecan Health - CA • Glendale, CA, USA
    [job_card.full_time]
    [filters_job_card.quick_apply]
    The Vice President of Revenue Cycle is a key executive role responsible for overseeing and optimizing the entire revenue cycle process within the organization. This position ensures the effective ma...[show_more]
    [last_updated.last_updated_variable_days]
    Senior Manager, EPM Solutions Lead, Finance Transformation

    Senior Manager, EPM Solutions Lead, Finance Transformation

    The Walt Disney Company (Corporate) • Sylmar, California, USA
    [job_card.full_time]
    The Oracle EPM Solution Lead will serve as the bridge between Finance and Technology, demonstrating the art of the possible within Oracle’s Enterprise Performance Management (EPM) suite.This role c...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Director of Group Sales

    Director of Group Sales

    The Fairmont Hotel • Long Beach, CA, United States
    [job_card.full_time]
    Fairmont Breakers is a beloved feature of the Long Beach skyline, a historic landmark with a character and soul of its own. Originally opened in the roaring twenties as a lavish hotel on the waterfr...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Senior Vice President, Regional Director - RIA | Bank Group

    Senior Vice President, Regional Director - RIA | Bank Group

    Aristotle Capital Management, LLC • Los Angeles, CA, United States
    [job_card.full_time]
    Aristotle is a majority employee-owned investment management organization with offices in Los Angeles, Newport Beach, Boston, and Sarasota. We specialize in equity and fixed income portfolio managem...[show_more]
    [last_updated.last_updated_1_day] • [promoted]
    Regional Director Grassroots

    Regional Director Grassroots

    Wounded Warrior Project • Los Angeles, CA, United States
    [job_card.full_time]
    We know these are some of the things people look for in a job.If you're the kind of person who believes that honoring and empowering our nation's veterans is more than just a cause - that it's a ca...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Director, Development (Corporate)

    Director, Development (Corporate)

    American Red Cross • Los Angeles, CA, United States
    [job_card.full_time]
    Please use Google Chrome or Mozilla Firefox when accessing Candidate Home.By joining the American Red Cross you will touch millions of lives every year and experience the greatness of the human spi...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Manager Touring - Global Touring

    Manager Touring - Global Touring

    AEG Presents • Los Angeles, CA, United States
    [job_card.full_time]
    For more than 20 years, AEG has played a pivotal role in transforming sports and live entertainment.Annually, we host more than 160 million guests, promote more than 10,000 shows and present more t...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Regional Account Manager, SLED

    Regional Account Manager, SLED

    Fortinet • Los Angeles, CA, United States
    [job_card.full_time]
    The Regional Account Manager (RAM) is an exciting role within the Fortinet sales organization that is focused on an important subset of the SLED (State, Local Government and Education) segment.This...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Director of Rooms

    Director of Rooms

    The Fairmont Hotel • Santa Monica, CA, United States
    [job_card.full_time]
    Situated atop the scenic bluffs overlooking Santa Monica Beach, Fairmont Miramar Hotel & Bungalows is just a stone's throw away from some of Southern California's best attractions including Santa M...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Director of Revenue Cycle

    Director of Revenue Cycle

    APLA Health • Los Angeles, California, United States
    [job_card.full_time]
    APLA Health provides quality healthcare, life-saving services, camaraderie, compassion, and comfort to all who come through our doors. Our dedicated team of healthcare professionals is committed to ...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Director, Client Services

    Director, Client Services

    Konica Minolta Business Solutions • Los Angeles, CA, United States
    [job_card.full_time]
    KMBS Paper Company has an exciting opportunity for a Director of Client Services!.In this role, you will focus on the following : . Ensure all client deliverables are met on time and within scope.Driv...[show_more]
    [last_updated.last_updated_1_day] • [promoted]
    Assistant Director of Food & Beverage

    Assistant Director of Food & Beverage

    The Fairmont Hotel • Long Beach, CA, United States
    [job_card.full_time]
    Fairmont Breakers is a beloved feature of the Long Beach skyline, a historic landmark with a character and soul of its own. Originally opened in the roaring twenties as a lavish hotel on the waterfr...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Director of Touring - Global Touring

    Director of Touring - Global Touring

    AEG Presents • Los Angeles, CA, United States
    [job_card.full_time]
    For more than 20 years, AEG has played a pivotal role in transforming sports and live entertainment.Annually, we host more than 160 million guests, promote more than 10,000 shows and present more t...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Senior Manager, Finance Transformation AI Lead

    Senior Manager, Finance Transformation AI Lead

    The Walt Disney Company (Corporate) • Hawthorne, California, USA
    [job_card.full_time]
    The Finance Transformation AI Lead drives strategic AI adoption for all finance teams, showcasing advanced AI capabilities in the context of Disney’s unique systems, data, and processes.This role s...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Mgr, Enterprise Programs and Platform Performance

    Mgr, Enterprise Programs and Platform Performance

    The Walt Disney Company (Corporate) • Sylmar, California, USA
    [job_card.full_time]
    The Global Security Control Center (GSCC) is responsible for supporting emergency and non-emergency events, researching global affairs, incoming call mitigation, event dispatching, and event-driven...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Senior Manager, Revenue Accounting

    Senior Manager, Revenue Accounting

    Relativity • Los Angeles, CA, United States
    [job_card.full_time]
    Relativity is looking for a Senior Manager, Revenue Accounting to manage and support revenue accounting functions including revenue recognition, contract review, revenue-related processes and contr...[show_more]
    [last_updated.last_updated_30] • [promoted]