Director, Revenue Cycle

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Position Overview

The Director, Revenue Cycle directs the Screening business unit, Revenue Cycle function. This position is responsible for the oversight of all processes and direction of business strategy across the department, leading the team, and driving the strategy of the entire revenue cycle process of a clinical independent lab. The Director, Revenue Cycle is responsible for ensuring monitoring tools are in place to track work metrics ensuring deliverables are being met while assuring consistent quality standards are being met.  This individual provides mentoring to Revenue Cycle staff, as needed, and serves as the liaison to various internal and external entities. They are responsible for communicating the health of the department to leadership teams via meetings, conference calls, presentations, and reports. The role also requires strong skills and experience in personnel management, Revenue Cycle systems, leading and building teams to foster a culture grounded by the core values of integrity, teamwork, innovation, and quality.

This position is remote.

Essential Duties

include but are not limited to the following:

• Direct, coordinate, and monitor the overall functions of the Revenue Cycle department.
• Ensures maximization of cash flow while improving patient, physician, and other customer relations.
• Oversees the claims submissions, accounts receivable follow-up, and reimbursement management.
• Develop and oversee the maintenance of the Revenue Cycle department’s systems, priorities, procedures, and policies.
• Design and oversee processes and procedures for the efficient and successful flow of interdependent information between the Revenue Cycle team and the third-party billing vendor, Accounting, Legal, Market Access, and Exact Sciences contact center.
• Oversee the designs and execution of key strategies and infrastructures to drive collection of earned reimbursement for lab operations.
• Monitor billing compliance with all third-party payer regulations.
• Oversee the investigation of denial sources, trends, resolves, and appeals with cross-functional team involvement.
• Oversee departmental processes to ensure compliance with performance metrics.
• Oversight, mentoring, and development of the leadership team, including directing managers in the daily management of their teams.
• Supervise staff; including, but not limited to, organize and prioritize work, write/conduct performance reviews, train/develop, and manage work performance.
• Communicate goals clearly to employees to ensure understanding and success in achieving them.
• Motivate and inspire employees to do their best work through coaching.
• Maintain morale and support employee engagement initiatives.
• Routinely audit current procedures to monitor and improve efficiency of Revenue Cycle operations.
• Ensure the activities of the Revenue Cycle function are conducted in a manner that is consistent with Exact Sciences policies, processes, and procedures and follow Federal, State, and payer regulations, guidelines, and requirements.
• Participate in cross-functional activities with vendors and other areas of the business on technology needs or improvement suggestions.
• Work with all the laboratory management teams as a senior mentor throughout all the development and implementation stages (scoping, planning, implementing, and maintaining) of strategy deployment.
• Identify and understand regulatory requirements in order to make sure the laboratory is in compliance with all applicable laws and regulations pertinent to the management of the laboratory; including as applicable CLIA, CAP and other requirements and regulations such as California and New York (CLEP) laboratory programs.
• Work cross-functionally across different operations within the organization.
• Strong managerial and leadership skills; including critical thinking and the ability to produce and present detailed billing activity reports.
• Uphold company mission and values through accountability, innovation, integrity, quality, and teamwork.
• Support and comply with the company’s Quality Management System policies and procedures.  
• Regular and reliable attendance.
• Ability to work on a mobile device, tablet, or in front of a computer screen and/or perform typing for approximately 90% of a typical working day.
• Ability and means to travel between Madison locations.

Minimum Qualifications

• Bachelor’s degree in Business, Healthcare Administration, or related field; or High School Degree/General Education diploma and 4 years of relevant experience in lieu of Bachelor’s degree.
• 10+ years of experience within the healthcare industry in a leadership capacity and influence over processes, procedures, staffing models, and training content and/or development.
• 5+ years of experience with the development of a Revenue Cycle team and workflows.
• 5+ years of experience with third party payers.
• 5+ years of experience working with International Classification of Diseases (ICD-9) and (ICD-10), Coding Procedure Terminology (CPT and HCPCS), and Coding Procedure Terminology (CPT and HCPCS).
• 5+ years of experience and thorough understanding of ASC X12 claims adjustment and remark codes.
• Demonstrated strong knowledge of managing claims processing.
• Demonstrated strong knowledge of Explanation of Benefits (EOB); must be able to read and interpret explanation of benefits (EOB) for all payers.
• Proficient in Microsoft Office.
• Authorization to work in the United States without sponsorship.
• Demonstrated ability to perform the Essential Duties of the position with or without accommodation.

Preferred Qualifications

• 5+ years of experience with Epic software.
• 5+ years of experience working with Quality Management; including strong knowledge of all laws and regulations that are required by CLIA, CAP, OSHA, and other related legislative and/or state health departments and organizations.

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Salary Range:

$161,000.00 - $257,000.00

 

The annual base salary shown is for this position located in US - WI - Madison on a full-time basis. In addition, this position is bonus eligible, and is eligible to receive company stock upon hire as well as annually.

Exact Sciences is proud to offer an employee experience that includes paid time off (including days for vacation, holidays, volunteering, and personal time), paid leave for parents and caregivers, a retirement savings plan, wellness support, and health benefits including medical, prescription drug, dental, and vision coverage. Learn more about our benefits.

Our success relies on the experiences and perspectives of a diverse team, and Exact Sciences fosters a culture where all employees can develop personally and professionally with a sense of respect and belonging. If you require an accommodation, please contact us here.

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We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to age, color, creed, disability, gender identity, national origin, protected veteran status, race, religion, sex, sexual orientation, and any other status protected by applicable local, state, or federal law. Any applicant or employee may request to view applicable portions of the company’s affirmative action program.

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