Lead and manage all aspects of the RCM process, including coding, billing, collections, and payer relations, ensuring alignment with company goals.
Establish a comprehensive RCM strategy to drive efficiency, minimize denials, optimize cash flow, and enhance the overall patient financial experience.
Work closely with the CFO and leadership team to integrate RCM processes with overall financial strategy, ensuring proper alignment with business objectives.
Develop, implement, and refine RCM workflows to streamline processes, reduce costs, and improve accuracy.
Continuously assess emerging trends and technologies in RCM to keep Luna ahead of the curve.
Lead, mentor, and build a high-performance RCM team of 40 professionals, fostering a culture of accountability, collaboration, and continuous improvement.
Provide training and development opportunities to grow team members' expertise and ensure high levels of engagement.
Set clear performance goals, conduct regular performance reviews, and ensure the team operates efficiently to meet revenue and operational targets.
Ensure seamless integration between RCM operations and the broader finance function, including budgeting, forecasting, and financial reporting.
Develop and maintain key performance indicators (KPIs) for RCM functions and ensure alignment with corporate financial goals.
Collaborate with the CFO on the preparation of financial reports, ensuring revenue cycle data is accurately reflected in financial statements.
Identify opportunities for improvement in billing processes, collections, and payer contracts to optimize revenue.
Collaborate with the payer contracting team to negotiate contracts and resolve payer-related issues.
Ensure that RCM operations comply with payer policies and regulatory requirements, maintaining audit readiness and mitigating financial risk.
Oversee the adoption and integration of advanced RCM technologies and software to improve process efficiency, data accuracy, and overall revenue cycle performance.
Drive initiatives to improve electronic billing, coding accuracy, and data analytics to ensure scalability as Luna grows.
Oversee the integration of health system partners under Master Services Agreements (MSAs) into Luna’s RCM processes, ensuring seamless data sharing, process alignment, and timely, accurate billing and collections.
Manage and ensure accuracy of partner monthly invoicing in accordance with contractual terms, collaborating with Finance to align invoicing processes and reporting requirements.
Foster collaborative relationships with health system partners, proactively addressing RCM challenges, sharing performance insights, and identifying opportunities for process improvements that enhance partner satisfaction and financial outcomes.
Requirements
10+ years of experience in revenue cycle management, with at least 5 years in a senior leadership role, ideally in a healthcare environment.
Proven track record of driving operational efficiency and aligning RCM with broader financial goals in a high-growth, multi-million-dollar business.
Experience managing large, diverse teams with a focus on development and performance optimization.
Strong understanding of healthcare financials, insurance reimbursement models, and payer relations.
Expertise in RCM software and technology, with a deep understanding of the latest trends in automation and data analytics.
Excellent communication and interpersonal skills, with the ability to influence and collaborate effectively across functional areas.
Data-driven decision-making ability, with a keen eye for identifying and implementing process improvements.
Bachelor’s degree in Finance, Healthcare Administration, or a related field required. MBA or relevant advanced degree preferred.
Certification in Healthcare Financial Management (CHFM), Certified Revenue Cycle Executive (CRCE), or other relevant RCM certifications are a plus.
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