Director of Revenue Cycle Management

This is a remote position.

ABOUT THE ORGANIZATION

Established in 1990 to be the Guardian of the Injured for the people of Hawaii Workstar effectively treats injured workers auto accident victims and chronic pain patients with the utmost care and compassion to help them return to a functional and fulfilling life. Workstar staff have over 100 years of occupational and industrial injury experience with 25000 closed claims and a 95% Excellence Rating in assisting employers and insurance carriers in the management of workers compensation injury recovery and associated costs.

ABOUT THE OPPORTUNITY

This Director of Revenue Cycle Management (RCM) for Pharmacy will be responsible for the leadership strategic direction performance operational deployment and evaluation of Workstar s internal pharmacy. It should be noted that the internal pharmacy only dispenses to Workers Compensation and NoFault Auto patients.

The director will be accountable for the overall success of the revenue cycle process including account management billing collections payment posting coding auditing communicating with insurance carriers/payers payor contract analysis and related negotiations and report analysis. The director will also be tasked with recruiting hiring training and managing a pharmacy billing staff of 35 people.

PRIMARY RESPONSIBILITIES AND DUTIES

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Develop and implement plans to maximize the efficiency of the pharmacy revenue cycle

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Analyze revenue cycle performance data (days in AR % of claims paid denial rate etc.) to develop guidelines/procedures and strategic goals of the pharmacy

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Recruiting hiring training and managing a pharmacy billing staff

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Develop budgets and cash flow forecasts for the pharmacy

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Other duties and special projects as assigned

QUALIFICATIONS AND SKILLS

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5 years of experience as a leader in revenue cycle management for a Workers Compensation Pharmacy or Workers Compensation Pharmacy Management Company

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Knowledge of ICD10 and CPT coding principles and guidelines

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Compliance of HIPAA regulations