Director of Revenue Cycle will take the lead on payer relations and contract negotiations in line with company goals and objectives and manage the overall activities and the centralized billing office’s associates. This includes maintaining and evaluating Key Performance Indicators associated with receivables management and net revenue optimization.
JOB SPECIFIC RESPONSIBILITIES
Liaise with contract consultant to ensure all contracts are current and active, as well as optimize net revenue through contract negotiation
Serve as lead corporate liaison to all payers
Ensure entities at all levels of the organization are informed about all terms of negotiated contracts and understand their role in ensuring contracts are implemented quickly and correctly
Assist in revenue validation routines
Ensure that CBO staff receives ongoing training/cross-training and are knowledgeable regarding all CBO functions
Perform all duties associated with staff management under the guidance of the VP of Finance to include but not limited to: staffing ratios, recruitment, performance behavioral counseling as necessary, timekeeping, and timely /periodic performance reviews in accordance with company policies, rules, and regulations, due process, and government regulations
Perform ongoing quality assurance audits and reviews of billing and collection processes and ensure all aging reports are being maintained effectively and timely
Ensure all billing and collection practices are compliant with local, State, and Federal guidelines and regulations
Assists facility personnel in resolving billing problems utilizing the patient accounting system.
Conduct follow-up collection efforts with facility CEOs and Corporate leadership as required
Maintain and enhance system functionality associated with the Meditech, including dictionary maintenance specific to billing, claims reimbursement, and staff work lists
Monitor, maintain, and enhance Key Performance Indicators associated with the CBO while further ensuring continuous process improvement
Participate in facility AR calls/AR reviews and able to provide appropriate status updates regarding active A/R to all leadership levels
Review, research, and maintain Chargemaster issues that impact proper claim submission and reimbursement
Monitor, track, and trend denials and appeals
Assist in timely closely of A/R subsidiary ledgers for all facilities and assist in the detailed account analysis
Provide analysis and detail for annual Cost Report and/or financial audits
Ensure responsibility for all adjustments, bad debt, and refunds for all facilities
Perform other duties as assigned
Minimum of five (5) years of management experience in healthcare finance/accounting/healthcare business office / and/or healthcare contracting setting
Business office experience with the Meditech Patient Accounting System and SSI Billing application preferred.
Excellent interpersonal, communication, facilitation, and professional diplomacy skills
Must be versed in all billing and collection guidelines for both government and non-government payer sources.
Strong attention to detail with the ability to manage multiple priorities while meeting deadlines
Possess strong communication skills to clearly and effectively communicate with physicians, management, and hospital staff
Highly organized and developed time management skills
Minimum Bachelor’s Degree in Health Care Administration, Business, or other related fields, or comparable work experience required.