Director, Revenue Cycle

Director, Revenue Cycle Monogram Health Inc

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1 Nashville, TN Job Details 1 day ago Benefits Paid parental leave Paid holidays Disability insurance Dental insurance Flexible spending account Parental leave Employee assistance program Vision insurance 401(k) matching Employee discount Life insurance Referral program Qualifications Medicare Phone communication Operational management Financial analysis Bachelor's degree Health insurance knowledge Medicare regulations Electronic health record (EHR) management for billing and coding Clinical documentation Healthcare team management Centers for Medicare & Medicaid Services (CMS) billing regulations Medicaid regulations Medicaid Clinical documentation standards Managing medical billing & coding team teams Client interaction via phone calls

Full Job Description Position:

Director, Revenue Cycle The Monogram Health Director, Revenue Cycle will have the opportunity to build and lead standard processes and a cross-functional team to optimize financial results and improve the patient experience. He or she will partner with coding, clinical, finance, compliance, and operations leadership to align the revenue cycle function with organizational goals around growth, quality, compliance, and member experience. The Director, Revenue Cycle will provide strategic leadership over revenue cycle reporting, denial management, self-pay billing and other related processes through data analysis and establishing scalable processes, policies, and controls. As a member of this team, this individual has exposure to all aspects of Monogram's business model and is immersed in the rapidly growing value-based care vertical of the healthcare industry. Responsibilities Oversee revenue cycle operations, including insurance verification, partnering with the coding team around charge capture/medical coding, billing/claims submission, payment posting, collections, denial management, self-pay billing, reporting, and patient billing inquiries. Develop and implement scalable operating procedures and policies, internal controls, and compliance frameworks. Ensure all revenue cycle operations meet federal/state regulations, payer requirements, coding and documentation standards (ICD-10, CPT, HCPCS, etc.), and privacy/HIPAA compliance; stay abreast of payer requirements and changes in the industry and communicate those changes to team members and leadership. Define and analyze revenue cycle KPIs (e.g., Days in A/R, denial rates, claim turnaround time, clean claim rate, cash collections, write-offs); monitor and report on KPIs to senior leadership, while identifying opportunities for process improvement. Lead, mentor, and manage staff across revenue cycle team — including performance management, training, documentation standards, and ongoing education on coding/payer regulations. Support Monogram Health as necessary with any tasks or projects required to deliver excellent personalized care Uphold the mission and values of Monogram Health in all aspects of your role and activities Position Requirements Bachelor's degree in finance or accounting required 7+ years of experience in claims operations management and revenue cycle Demonstrated experience managing and scaling a revenue cycle team in a complex healthcare environment (multi-specialty care, value-based or risk-based care models preferred). Excellent verbal communication skills both in person and over the phone Analytical skills, financial acumen, and proficiency with revenue cycle management systems / EHR / billing platforms Working knowledge of ICD-10, HCPCS, and CPT coding Understanding of Medicare, Medicaid, and third-party billing/coding guidelines and clinical documentation requirements Highest standards of accuracy and precision; highly organized Benefits Comprehensive Benefits

• Medical, dental, and vision insurance, employee assistance program, employer-paid and voluntary life insurance, disability insurance, plus health and flexible spending accounts Financial & Retirement Support
• Competitive compensation, 401k with employer match, and financial wellness resources Time Off & Leave
• Paid holidays, flexible vacation time/PSSL, and paid parental leave Wellness & Growth
• Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts About Monogram Health Monogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions.

Monogram health takes a comprehensive and personalized approach to a person's health, treating not only a disease, but all of the chronic conditions that are present

• such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.

Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient's healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home. Monogram Health's personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum.