Position Summary / Career Interest:
Responsible for directing revenue cycle and related functions including credentialing, charge entry, reimbursement and collections. Ensures optimum reimbursement for medical services through accurate and timely reporting of all physician services. Directly supervises assigned revenue cycle process to ensure the shortest possible collection time. Directs the employee and outsource vendor workflow and performance. Provides direction and leadership to departmental staff, ensuring a high level of customer service is provided. Interacts closely with clinical staff and departments on revenue cycle workflows. Manage revenue cycle vendor support relationships and performance. Directs the development and distribution of revenue cycle reports. Supports and adheres to The University of Kansas Health System’s Code of Ethics and Business Standards.Position Description:
- Directs the operational performance and overall management of the Physician Revenue Cycle Service teams including: credentialing, charge entry, medical coding, reimbursement and collections.
- Prepares and monitors department budget.
- Collaborates with the Director of Health Information Management to ensure consistent direction and policy adherence to medical coding staff.
- Ensures accurate and timely processing of assigned functions by establishing and maintaining quality and productivity measures are in place, reviewed and acted on appropriately.
- Work closely and collaboratively with Revenue Cycle Leadership Team and Revenue Integrity Director to optimize outcomes.
- Establishes tracking, trending and reporting of payer performance.
- Develops denial management and initiates steps for denial prevention.
- Manages payer underpayment and overpayment reporting and resolution.
- Implements and monitors compliance with UKHA and governmental and managed care reimbursement policies and regulations.
- Stays abreast of industry trends and drives revenue cycle strategy within assigned area.
- Maintains a working knowledge of applicable laws, regulations and payer contract agreements as they relate to assigned responsibilities and educates staff appropriately.
- Establishes, maintains and monitors performance of outside vendors supporting assigned responsibilities.
- Directs physician participation processes to ensure physicians are credentialed in a timely manner and front office is appraised on changes in participation.
- Collaborates with staff and departments with the overall goal of improving revenue cycle processes, including minimizing bad debt and administrative write-offs, reducing accounts receivable while maintaining a high level of cash collections, reduce claim submission lag, and maximize use of human and capital resources efficiently.
- Provides leadership, motivation and inspiration to managers and staff within the department.
- Focuses on departments internal and external stakeholders and support the team’s ability to deliver a high level of customer service and meet customer expectations.
- Provides feedback and works directly with clinical staff and departments to identify trends and to develop and implement action plans for improving revenue cycle workflows.
- Establishes and monitors reports to provide overall status of assigned functions and identify trends.
- Shares reports and results as appropriate.
*Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
*Note: These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.
- Master’s Degree in a related field
- 2 years business leadership experience
- Designated Epic training to be completed within 6 months of hire
- Demonstrated organizational ability to plan and control activities of work groups; to relate to people to win confidence and establish rapport; and to create a work environment supporting and encouraging flexibility to adjust to changing conditions and priorities.
- Proficient in Excel, Word, PowerPoint
- Epic experience
- Ability to read, speak, and write Spanish