Director, Revenue Cycle

Steward Health Care   •  

Fall River, MA

5 - 7 years

Posted 254 days ago

This job is no longer available.

Provides managerial support and leadership in conjunction with facilitating all functions and areas within Patient Access and HIM, including information desk, registration, admissions, bed placement, insurance eligibility verification, pre-authorization, community wide scheduling and co-pay collections. Manages the function of gathering, storage, retrieval and dissemination of medical information for inpatients and outpatients of the hospital. Plans, organizes, directs and develops systems operations in the Health Information department and library. Establishes, maintains and enforces all departmental policies; ensures compliance with all regulatory and accreditation agencies. Responsible for ensuring the smooth and productive operations 24/7 in all areas. Works closely with Patient Access leads, Coding Manager, and HIM Supervisor to resolve problems. Acts as a liaison to the IS department and Financial Services regarding departmental issues and changes. Interacts with patient care and services departments, and physicians' offices regarding processes and services provided by all areas. Handles personnel activity of staff including recommendation for hire, termination, promotion and discipline. 


• Staff/Department Management: Oversees and directs planning, organizing and implementing Patient Access and HIM processes and functions, including Information Desk. Provides for all department staff orientation, in-service training and continuing of education. Responsible for staff personal development and professional growth through seminars, conferences, staff meetings, etc. Accountable for all day to day operations 24/7. Ensures timely scheduling and appropriate staffing levels to provide good customer service. Responds to special problems and emergencies on a 24/7 hour basis. Participates in patient safety initiatives and trains staff appropriately. Participates in and oversees staff interviews, hiring, terminations and disciplinary actions in accordance with hospital policies. Monitors revenue cycle dashboard metrics, implements initiatives to improve metrics including POS cash collections, Medicaid application completion, revenue protect compliance, DNFB and clean claim rates.
• Organizational Relationships: Coordinates processes with Administration, Physicians, Nursing, Fiscal Services, ER staff, in planning, goal setting, financial screening and managing development projects. Oversees coordination and integration of intradepartmental services, including pre-registration, scheduling and financial counseling. Works closely with nursing to manage patient bed assignments. Plans, coordinates and directs all functions of Patient Access, HIM, Community Wide Scheduling, Financial Counseling, Cashier's and Information Desk including initiatives across all departments.
• Quality Control: Evaluates, recommends, and implements changes to improve Patient Access and HIM department processes and to optimize reimbursement to the hospital. Responsible for involving staff in continuous quality improvement activities; motivates and empowers staff to improve. Monitors and reports quality improvement activities.
• Administrative Responsibilities: Attends Medical Records committee and monthly Steward Patient Access and HIM Enterprise Group meetings. Attends and participates on committees as requested; chairs and coordinates activities of the Registration and Scheduling Workgroup. Accountable and responsible for Patient Access department, HIM and Information Desk budgets and for monitoring expenses and budget variances. Assists in computer system upgrades, testing and oversees smooth functions of all systems. Integrates responsible department's services with the hospitals primary functions. Provides leadership that fosters an atmosphere that is conducive to the fulfillment of the hospitals mission. Monitors compliance with department, hospital and Steward policies and procedures. Keeps Vice President of Finance informed of both departments activities, needs and problems. Monitors established Patient Access and HIM goals and objectives to ensure that measurable standards are met each month. Works closely with Revenue Enhancement team to minimize reimbursement loss.
• Demonstrates respect and regard for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment.
 Commits to recognize and respect cultural diversity for all customers (internal and external).
 Communicates effectively with internal and external customers with respect of differences in cultures, values,   beliefs and ages, utilizing interpreters when needed.
• Performs other duties as assigned


• Math skills, strong organizational skills working knowledge of all types of healthcare insurance.
• The ability to analyze and evaluate information, exercise own judgement, interpret hospital policies and procedures, anticipate department needs.
• Leadership ability with effective communication, motivational, and critical thinking skills.
• Ability to work independently.
• Requires effective use of problem solving, negotiating, conflict management, team leading and teambuilding skills.
• Must possess ability to communicate well in written and verbal forms with others, both internally and externally.


Education:  Bachelor's Degree preferred. Associate's Degree will be considered with considerable healthcare experience.
Experience: Minimum of seven years' experience in an acute healthcare environment. Three to Five years supervisory experience preferred.
Certification/Licensure:  None.
Software/Hardware: General Office equipment, Meditech, Microsoft Word, Excel and PowerPoint.