Director, Revenue Cycle

Fidelis Care   •  

Albany, NY

Industry: Healthcare IT


5 - 7 years

Posted 368 days ago


Director, Revenue Cycle


Fidelis Care offers quality, affordable coverage to residents across the State of New York, including products available through Medicaid, Medicare and the NY State of Health. Fidelis Care was founded on the belief that all New Yorkers should have access to affordable, quality health insurance and that remains our mission to this day to our more than 1.6 million members.

Position Summary – Director Revenue Cycle

The Finance Team at Fidelis Care has an exciting  new opportunity for a Director of Revenue Cycle within our New York City Office. This position provides day to day guidance and tactical direction to a team of analysts responsible for billing and collections operations for all Fidelis lines of business including: Medicaid, Medicare, MLTC, MAP, FIDA, and Qualified Health Plans.  The Director of Revenue Cycle is also responsible for billing and collecting for enhanced state reimbursements related to maternity and new bornclaims.  

Primary Responsibilities

  • Provides guidance and strategic direction to a team of Revenue Cycle Professionals
  • Responsible for all aspects of billing and collections for all Fidelis products.  Iincluding ensuring accurate billing of rates, and membership by product updates.
  • Provide SME analysis of billing, collections and outstanding receivables to Senior and Executive Management
  • Develop data structures to facilitate the analysis of revenue and rate trends that exist within the business and coordinate with medical economics and actuary to recommend cost-saving initiatives in a meaningful way
  • Assess the accuracy of billing and payments; address queries from internal and external customers; analyze fluctuations in Fidelis’ reimbursement amounts; drive process improvement to maximize financial results; oversee the collection and analysis of information;  summarize trends; prepare special financialreports regarding payments received and outstanding receivables.
  • Collect, analyze, and summarize information in order to prepare standard and ad hoc financialreports
  • Communicate experience  to Senior Management
  • Assist in providing support to otherfinance departments such as accounting, and coordinate with those departments on monthly close
  • Recruit, select, orient, and train employees in order to maintain staff to meet objectives. Provide information, educational opportunities, and experiential growth opportunities in order to develop staff. Plan performance expectations

Preferred Skills/Experience

  • Five years Leadership experience, required
  • Managed care and healthcareexperience, required
  • Experience wWorking in hHeavily rRegulated eEnvironment, required
  • BA/BS - BachelorsBachelor’s Degree, required
  • MHA/MS/MBA - Masters Degree or equivalent, preferred
  • Ability to Monitor compliance of departmental policies and procedures to meet organizational initiatives and regulatory requirements
  • Business Analysis Knowledge: Skilled to work in a fast paced environment. Must have strong analytical and problem solving skills
  • Customer Service: Skilled to communicate with all levels of Management, internal and external customers
  • Effective Business Communication: Skilled in communicating with technical and business constituencies in writing effective business specifications and requirements
  • Proficiency in Microsoft Office: Excel, Word, Access; Outlook; PeopleSoft; Crystal Reports