Client Success Director, RCM

Role Overview

• Serve as the primary point of contact for assigned clients and promptly respond to all client inquiries
• Engage in regular client interaction via e-mail, conference calls, and in-person visits to ensure customer satisfaction
• Interface with assigned client service staff to ensure the appropriate preparation, analysis, and presentation of all client deliverables, ensuring their accuracy and overall quality
• Proactively identifies potential problems with client performance before they occur and develops and implements a plan to eliminate future occurrences
• Ensures that all appropriate resources are available and utilized effectively to maximize account performance
• Monitors, evaluates, and reports on billing effectiveness/cash flow, and makes recommendations to increase productivity and profitability
• Remains current on payment trends and coding, and payer requirement changes. Acts upon variances to explain, correct, or enact desired process improvements
• Generates client standard and ad hoc reports to clients, including commentary on the value nimble provides the client
• Develop and execute a centralized, high-performing RCM strategy that aligns with the organization's growth objectives, including new center acquisitions and service line expansion
• Establish, monitor, and report on key performance indicators (KPIs) for the entire revenue cycle (e.g., Days in A/R, Net Collection Rate, Denial Rate, First Pass Acceptance Rate). Implement data-driven strategies for continuous improvement
• Provide regular, comprehensive performance reports, variance analysis, and actionable insights to the executive team, physician partners, and board members
• Oversee and standardize all front-end processes, vendors, direct patient payments, and point-of-service collections to minimize downstream errors
• Ensure timely and compliant charge capture and medical coding (CPT, ICD-10, HCPCS) specific to ASC procedures. Implement internal auditing programs to maintain accuracy and compliance
• Direct all billing, claims submission, and accounts receivable (A/R) follow-up activities to ensure prompt and accurate payment from government and commercial payers
• Lead a robust denial prevention and management program, conducting root cause analysis, implementing corrective actions, and overseeing the timely appeal of denied claims to maximize reimbursement
• Collaborate with the Managed Care team to provide strategic input into payer contract negotiations, ensuring favorable terms, accurate fee schedules, and compliance with all contract language
• Monitor payer performance scorecards to track payment lags, underpayments, and denial trends, promptly engaging payers to resolve systemic issues

Requirements

• Solid background in all aspects of physician revenue cycle management, including at least two years in accounts receivable, coding, or payer contracting
• ASC billing experience preferred
• Proficient knowledge of third-party billing and claims processing procedures, including a solid understanding of the current regulatory environment
• Experience using Practice Management and EMR systems as it relates to production and client reporting.
• Strong analytical and critical thinking skills
• Strong communication skills, verbal and written
• Ability to work with a high degree of independence; must be proactive
• Proven client relationship skills; must be able to work effectively with physicians and senior management

Benefits

• Hybrid Setting – this role requires 1-2 days per week onsite at the client in Irvine, CA
• Participates in departmental, training, and staff meetings
• Adhere to all compliance and company policies and procedures
• Travel up to 20%