Director of RCM Operations - Pain Management

Apply directly or send your resume to recruiting@assembly.health

Become an Assembler! We are looking for a Director of RCM Operations to join our Doctor’s Choice team in the Physician RCM Division. If you are looking for a company that is focused on being the best in the industry, love being challenged, and make a direct impact on our business, then look no further!  We are adding to our motivated team that pride themselves on being client-focused, biased to action, improving together, and insistent on excellence and integrity.

This is a full-time, exempt position reporting to our CEO of Doctor’s Choice.

What you'll do

  • Develop and execute a comprehensive revenue cycle management strategy specifically tailored to pain management services, aimed at increasing revenue, reducing denials, and optimizing billing processes.
  • Become the go to source of information for all things pain management - keep up with LCD’s, Compliance issues, rules and regulations, etc.
  • Collaborate with the executive team to establish revenue goals and performance metrics, and regularly report on progress and key performance indicators (KPIs).
  • Serve as the main point of contact and trusted advisor for key Assembly Health and Doctor’s Choice clients, actively engaging with their leadership and finance teams to understand business objectives and aligning revenue cycle processes accordingly.
  • Oversee the end-to-end billing and collections processes, from charge capture to reimbursement, to ensure timely and accurate submission of claims and a reduction in payment delays.
  • Implement best practices to streamline workflows, improve coding accuracy, and minimize billing errors, aiming for optimal revenue realization.
  • Develop and implement an effective denial management process to identify root causes of claim denials and implement corrective actions to reduce future denials.
  • Collaborate with relevant teams to prepare and submit appeals for denied claims, ensuring maximum reimbursement for services rendered.
  • Analyze revenue cycle performance data regularly such as collection and denial rates, days in AR, identify trends, and proactively address any potential issues or opportunities for improvement.
  • Prepare detailed reports and presentations for the executive team, showcasing revenue cycle performance, areas of success, and recommendations for enhancement.
  • Provide ongoing updates to Physician/Divisional Manager education on changes related to Payers/Coding/ICD10 and LCD (Forward LCD’s to providers regularly)
  • Manage ERA Optimization and ACH Optimization for each client.
  • Collaborate/Oversee/Manage Offshore Pain Management Teams to ensure best practices/training of new offshore team members.
  • Create SOP’s for offshore team
  • Monitor reimbursements to ensure fee schedule compliance.
  • Annually update Medicare Fee Schedules in ECW.
  • Other tasks as needed.

What we're looking for

  • Bachelor’s degree in healthcare administration, Finance, Business, or a related field. A master’s degree is preferred.
  • CANPC Certification preferred.
  • Proven experience in revenue cycle management within the healthcare industry, with specific expertise in pain management billing.
  • In-depth knowledge of healthcare billing regulations, coding, and reimbursement practices.
  • Strong leadership skills with a track record of successfully managing teams and fostering a positive work environment.
  • Excellent communication and interpersonal abilities to effectively liaise between clients and Assembly Health.
  • Analytical mindset with a focus on data-driven decision-making and performance optimization.
  • Demonstrated ability to adapt to evolving industry trends and regulations and implement necessary changes to maintain compliance.
  • Ability to travel required.
  • Ability to function well in a fast-paced and at times stressful environment.
  • Prolonged periods of sitting at a desk and working at a computer. Ability to lift and carry items weighing up to 10 pounds at times.

Why join the team?

  • Be part of something special! We are growing both organically and through acquisitions.
  • Career growth - your next role with Assembly might not be created yet and we are waiting for your help to chart the way!
  • Ongoing training and development programs
  • An environment that values transparency
  • Virtual and in-person events to connect with your team.
  • Competitive Benefit Packages available, Paid Holidays, and Paid Time Off to enjoy your time away from the office.

Application

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