Associate Director, Audit- Revenue, Processes and Personnel
Remote
We are seeking an experienced and strategic Associate Director, Revenue Cycle Management Audit and Process Improvement to build and manage a comprehensive audit program for our revenue cycle processes and personnel. The ideal candidate will have a proven track record of leading revenue cycle audits, preferably within the labs/medical testing industry, and possess a deep understanding of the entire labs process from sample intake to billing.
Key Responsibilities
- Develop, implement, and manage a comprehensive audit program for revenue cycle, including process and personnel audits
- Direct audits and analysis, identify trends, present opportunity areas, and prioritize initiatives for performance improvement
- Identify areas of risk and recommend strategies to mitigate potential revenue loss
- Monitor key performance indicators and SLAs to ensure optimal process and personnel performance
- Collaborate with cross-functional teams, especially billing, to address audit findings and implement corrective actions
- Review and improve auditing templates with an effective scoring methodology to monitor RCM team performance
- Modify workflows, SOPs, and SLA tracking based on audit findings
- Oversee vendor operations teams to ensure accurate and timely processing for optimal reimbursement
- Lead weekly meetings to review key metrics, workflows, trends, and performance improvement opportunities
- Develop performance goals and metrics aligned with the organization's strategy
- Supervise and mentor audit staff to enhance professional development
Qualifications
- Bachelor's degree in Accounting, Business, Healthcare related field, or equivalent experience
- 8-10 years of related experience in medical billing and/or insurance collections, including 5-7 years of experience with Prior Authorization requirements, AR & Denial management, payer utilization management policies, and appeals
- Certified in coding or similar coding management experience
- Proven experience leading revenue cycle audits and managing audit programs
- Lab & Diagnostic industry-based RCM experience
- Management experience required
Required Skills
- Ability to analyze information and create compelling stories at the executive level
- Understanding of the entire labs process and ability to create scalable processes
- Knowledge of denial reasons and resolution strategies
- Strong communication and collaboration skills
- Proficiency with medical billing systems, Microsoft Excel, medical terminology, and basic procedure coding
- Motivated to be creative and brainstorm innovative solutions
- Desire to work for a dynamic and growing molecular genetics laboratory
If you are passionate about driving performance improvement in revenue cycle management and thrive in a fast-paced, innovative environment, …
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Benefits/Perks401k benefits Commuter benefits Competitive Competitive benefits Comprehensive medical Dental Employee Referral Program Fertility care Fertility care benefits Free testing Innovative solutions Life and disability plans Pregnancy and baby bonding leave Professional development Vision
Tasks- Analysis
- Identify trends
- Monitor key performance indicators
- Process Improvement
Audit Billing Coding Collaboration Collection Communication Cross-functional Teams Denial Management Excel Genetics Genetic Testing Healthcare Insurance collections Management Medical Billing Medical billing systems Medical terminology Microsoft Excel Molecular diagnostics Oncology Operations Orientation Prior authorization Process Improvement Reimbursement Revenue Cycle Management SOPS Testing
EducationAccounting Bachelor's Bachelor's degree Bachelor's degree in Accounting Business Equivalent Equivalent experience Genetics Healthcare Healthcare related field Oncology Related Field Software