Job Summary and Responsibilities: The Dir, Revenue Cycle Operations is responsible for the overall functions of the Hackensack University Medical Group (HUMG) professional fee revenue cycle to ensure maximum revenue and cash flow, while maintaining the highest levels of patient, physician, employee and other customer satisfaction. This includes management oversight of all business related functions of the patient visit from point of entry to accurate adjudication of the patient's account.
Specific areas of responsibility include registration, billing and collections, patient insurance, data processing, integrity of patient accounts, accounts receivable management and, the integrity and utilization of revenue cycle information system(s) tools. Responsible for the direction of these efforts to ensure the accuracy and timeliness of access, registration, charge capture, charge entry, claims submission, follow-up and account adjudication.
The Dir, Revenue Cycle Operations will manage and further grow the capacity of the specialized staff within the revenue cycle division, with particular emphasis in increasing effectiveness and accuracy of charge capture, charge entry, claims submission, follow-up and account adjudication, end user training and customer service. The Dir, Revenue Cycle Operations is responsible for ensuring revenue cycle management functions are aligned and optimized to maximize collections, advance the use of technology, optimize staff productivity, and minimize the cost to collect.
Direct Areas of Oversight
1. Manager, Revenue Cycle Operations
2. Revenue Cycle Analysts
3. Patient Account Coordinators
4. Ambulatory Epic Trainers/Operations Analysts
5. Customer Service
6. Vendor Management
1. Works with HUMC/HUMG executive leadership to deploy revenue cycle standards for a multi-entity integrated physician practice organization.
2. Leads and participates in the development of EPIC Ambulatory and PB revenue cycle modules system across Hackensack University Medical Group.
3. Leads the implementation of best practice revenue cycle standards to be followed by all HUMG physician practices.
4. Leads a team to ensure the management of patient accounts are accurate and timely resulting in the optimization of the entire revenue cycle.
5. Builds, plans, organizes and provides administrative direction and oversight for revenue cycle functions: registration, charge capture, charge entry, claims submission, follow-up and account adjudication, end user training and customer service.
6. Provides technical expertise to proactively drive and implement best practices across the revenue cycle.
7. Provides leadership and guidance to revenue cycle staff including the establishment of an organization structure to facilitate growth.
8. Ensures timely and accurate completion of:
a. Monthly, quarterly and annual physician revenue cycle reports.
b. AR management.
c. Monthly reporting on entity, departmental and provider KPI's.
9. Participates in leadership meetings and EPIC build sessions related to revenue cycle.
10. Provides revenue cycle support and setup for practice acquisitions and new provider hires.
11. Leads various meetings with physicians, practice operations, revenue cycle management and external vendors.
12. Responsible for working with practice leadership to identify opportunities for improving cash flows.
13. Responsible for working with practice leadership to explain and eliminate variances to budgets and projections related to cash collections and productivity metrics.
14. Responsible for developing training curriculum to assure that ambulatory epic workflows support best practice revenue cycle operations.
15. Works with and coordinates with third party revenue cycle by, reviewing/understanding practice KPI's and various operational revenue cycle activities.
16. Adheres to and supports the mission, purpose, philosophy, objectives, policies, and procedures of HUMC.
17. Adheres to HUMC HIPAA Compliance Plan and the Privacy Standards Confidentiality Agreement.
18. Demonstrates support for the HUMC/HUMG Corporate Compliance Program by being knowledgeable of compliance responsibilities as expressed in the Code of Conduct; adhering to federal and state laws, rules, regulations, and corporate policies and procedures policies that affect his/her specific job functions/responsibilities; and reporting compliance issues/concerns in a timely and appropriate manner.
Education, Knowledge, Skills and Abilities Required:
1. Minimum of 7 years of progressively responsible professional fee billing experience, some of which must be within an academic medical center environment.
2. Proven record of successful project management pertaining to revenue cycle, business processes, and technology utilization.
3. Demonstrated proficiency with application of budget, cost, and staff productivity management.
4. In-depth knowledge of federal and state regulations as they pertain to physician and other healthcare provider reimbursement.
5. Considerable knowledge of academic practice environment.
6. Knowledge of sophisticated professional billing software is required.
7. Ability to orchestrate change to improve workflow and effect positive organizational outcomes.
8. Strong customer service skills.
9. Outstanding communication skills, both written and verbal, with the ability to convey a positive and professional image in person, and to interact effectively with diverse personalities and back rounds.
10. Demonstrated ability to compromise, cooperate, and negotiate.
11. Strong analytical and financial skills.
12. Ability to meet deadlines to achieve critical organizational objectives.
13. Ability to multi-task.
14. Ability to work independently and exercise discretion and judgment.
15. Proficiency with Windows-based software and Microsoft Office Suite products in a network environment.
Job ID 20114