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The Director of RCM is responsible for defining and implementing strategy, processes, and initiatives that secure sustainable stable revenue cycle operations and collections, through leading the assigned areas of responsibility as assigned, including but not exclusive to the main functions of Insurance Verification, Prior Authorizations, Order Validation, Billing, Returns, Collections, Posting. As a member of the Comfort Medical leadership, this critical role sets the tone for ensuring, processes, systems, and approach are optimized for a compliant and profitable business execution while delivering an excellent service experience. This role works closely with other functions across the Comfort Medical, Coloplast North America, and Coloplast A/S teams.
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Major Areas of Accountability
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- Leadership and team management - Leading, guiding, evaluating, hiring, and managing the work of direct reports in the Revenue Cycle organization with the explicit goal of driving profitable growth in line with set objectives, regularly meeting with leadership team/direct reports to communicate direction and stay informed of the performance of the business, while holding team accountable to department goals.
- Revenue Cycle Management (RCM) - Responsible for RCM organization as defined by the company and maintaining departmental standards to secure quality of revenue, quality of execution, and timely completion of departmental tasks, as well as sustained high rates of cash collections.
- Credentialing and Licensing liaison – Signatory on all payor claims, including CMS, state and commercial payors. As signatory on all credentialing and licensing documents, the Director works closely with the Credentialing & Licensing department, to maintain business integrity, credentialing, business audits, both internally and externally (examples: MAC, RAC audit & CMS matters). Actively partakes in monitoring updates in Medicare/Medicaid/Commercial payor regulations and communicates/collaborates with Finance Manager, Supervisors, and departments affected by such changes to ensure that staff is properly trained in regulatory changes that affect reimbursement practices.
- Processes and enterprise systems – Proactively seeks opportunities in the development, implementation, and ongoing maintenance of approaches to support our customer experience and RCM practices while driving efficiencies. This includes providing input, feedback, and approval of processes and business decisions within Comfort Medical, ensuring compliance with all applicable US laws, regulations, as well as Coloplast standards and policies.
- Assure all processes and SOPs are are in compliance with our HIPAA privacy standards, all state and local laws, our Accrediting agency, OSHA, Medicare/Medicaid, Third-Party and private payor guidelines.
- Continuously report progress, KPIs, plans, and results to VP, Comfort Medical Finance, and other stakeholders in Coloplast Corp
- Comfort employees are required to conduct business to the highest ethical and professional standards; comply with applicable laws and regulations, the Advamed Code of Ethics on Interactions with Healthcare Professionals, and company policies.
- Other duties as assigned
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Essential Qualifications
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- Bachelor’s in Business, Economics, Finance or equivalent
- Minimum of 10 years’ experience in FP&A or similar role
- Minimum of 10 years’ experience managing a team in a fast-paced DME or healthcare environment
- Strong financial and business acumen and excellent strategic business understanding
- Knowledge of Medicare and regulatory billing codes, specifically of diagnostic and procedural terminology, ICD and CPT/HCPCS coding systems and compliance rules
- Able to effectively communicate with all levels and areas of the organization, leading multiple projects and manage deadlines; proficient in English
- This is a hybrid position, based in our Minneapolis office. Must have the willingness and ability to travel, including overnight – up to 30%
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Required Knowledge, Skills and Abilities
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- Exceptional interpersonal skills with a high degree of personal integrity, compassion and savvy to foster a collaborative and partnership-based approach to achieve company initiatives, with both internal business partners, as well as, external companies.
- Excellent written and verbal communication skills coupled with solid financial and business acumen
- Skilled project management in terms of both leading the thought content and managing the process
- Experience working and managing in a global environment
- Experience working effectively across cultures and countries, in a matrixed global environment
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