Manages and directs middle revenue cycle activities to ensure accurate and timely charge capture for each facility in the Service Area. Responsible for CDM compliance, pricing, and education/training of staff and revenue departments. Conducts regular patient charge audits to ensure accuracy and areas for improvement. Oversees the bill hold and suspended charge processes and provides continuous process improvement to reduce denials. Builds collaborative relationships with internal and external stakeholders to achieve Dignity Health Revenue Cycle Management goals and objectives.
- Identifies areas of opportunity to avoid non-covered and medical necessity denials and process improvements thatwill lead to less lost revenue
- Ensures appropriate compliance with Charge Master and revenue capture processes for new clinical services being considered by the facility.
- Oversees all patient charge audits performed by audit staff including requests from patients and payors and coordinates the timely resolution of patient account billing issues originating from Patient Financial Services.
- Oversees the bill hold processes performed by revenue integrity analysts for various departments; observation log; removing bill hold from accounts; posting appropriate charges as needed.
- Provides analysis, communicates and reports revenue cycle performance indicators/metrics including but not limited to Artiva assist requests, edits, missed/late charge capture, avoidable adjustment and denials. Monitors departmental usage of reports to ensure issues are being identified and addressed with continuous process improvement in addition to providing education to departments on improving revenue accuracy.
- Performs other related duties as assigned or requested.
- Knowledge of current and possible future policies, practices trends and information that can affect Dignity Health.
- Ability to take prompt action to accomplish objectives; taking action to achieve goals beyond what is required; being proactive.
- Ability to work effectively and cooperatively with others; establish and maintain good working relationships. Strong team orientation, collaborates to achieve common goals that contribute to the overall successes of the organization.
- Ability to effectively meet customer needs; build productive customer relationships; take responsibility for customer satisfaction and loyalty.
Education and Experience:
- Experience: Minimum of five (5) years of progressive experience in managing healthcare business functions and minimum of five (5) years of revenue integrity or revenue cycle experience.
- Education: Bachelor's degree in business, health or public administration, management, or a related field required. Master's degree in hospital or business administration, accounting, finance or a related field preferred.
- Licensure: None specified
- Special Skills: Exceptional verbal, interpersonal, and written communication skills. Ability to influence key stakeholders at various organizational levels. Strong leadership skills and commitment to a team approach; both direct and indirect reports. Competency in developing efficient and effective solutions to complex business challenges. Familiarity with management reporting, metrics and goal setting. Excellent knowledge of revenue cycle and otherhealthcarefinancial performance metrics. Deep familiarity with revenue cycle policies and procedures. Extensive knowledge of current healthcare trends, policies, and regulations. Understanding of coding classifications systems such as, but not limited to, ICD-10-CM, ICD-9-CM, MS~DRG, APR~DRGs, and HCCs strongly preferred. Comprehensive understanding of computer, database, and networktechnologies.
- Training: None specified
Job ID 2017-41699