The Director of Finance & Revenue Cycle, Physician Practices will report to the Chief Financial Officer for SJHS. He/she oversee and provide both the daily and the long-term direction of the Physician Practice Revenue Cycle function to ensure the department meets the SJHS, SJPA, Revenue Cycle Team, and departmental goals and objectives for operational, strategic, quality improvement, financial and other performance measures. As such, this Director will ensure successful registration, coding, patient and third-party billing and collections, payment posting, customer service and provider credentialing for the division through a matrix accountability structure, supporting both the VP-Revenue Management and the Senior VP-Physician Practice Management. This position will also provide consultative direction for Professional service billing functions to other entities within St. Joseph Health System as directed by the Chief Financial Officer.
Required: Bachelor's Degree
Preferred: Master's Degree
Required: Business Administration, Healthcare Administration, or Finance/Accounting.
Preferred: Business Administration, Healthcare Administration, or Finance/Accounting.
Required: More than seven years of experience with progressive leadership overseeing physician practice revenue cycle functions.
Preferred: Ten plus years of experience in same / similar role in large complex physician organization.
Required: Excellent grasp of physician practice revenue cycle process; knowledge of physician practice billing systems and governmental payment systems; Strong analytical, communication, and presentation skills; Ability to assess and evaluate complex financial data; strong working knowledge of Medicare and Texas Medicaid rules and regulations; strong knowledge of third party reimbursement policies and practices; Experience working with physicians and clinical staff; ability to supervise, train, and motivate employed and contracted staff; excellent skills with MS Office and related products.
Preferred: Experience with E-Clinical Works Physician billing system and Meditech hospital information system.
Preferred: CPA or similar designation is desirable.
Departmental Leadership: Administers written and verbal guidance in order to engage the employed and contract staff in the Revenue Cycle functions for Physician Practice Management operations. Establishes, implements, and manages effective pre-registration, authorization, registration, coding, charge capture, billing, collection, payment posting, A/R and credit balance management, customer service, and provider credentialing processes that enable stakeholders to access, interpret, and adjudicate billings for services provided by SJPA and related entities. Ensures processesassociated with these policies, procedures, and functions are based on best practices, and are easy-to-use, timely, effective, and efficient. Ensures that these processes are designed to achieve the organizational goals of SJHS, SJPA, SJRHC, the Revenue Cycle Team, and the department. Maintains ongoing compliance with organizational, regulatory, contractual, and/or accreditation requirements (i.e. Organizational policies, CMS regulations, state regulations, payor contractual obligations, etc.).
Quality of Performance: Establish metrics to track and ensure the efficient function of the Physician Practice Management Revenue Cycle. Develop and prepare appropriate reporting tools to track the performance of appropriate key indicators across the Physician Practice Management revenue cycle. Evaluate physician practice coding operations and implement changes to improve compliance and revenue integrity. Review and recommend changes / updates based on current coding methodologies and releases. Actively supports the implementation of the Malcolm Baldrige management framework for performance excellence. Develops and deploys quality improvement initiatives based upon the SJHS process improvement methodology - PIE-PDCA format and/or LEAN management principles. Prepares and presents quality initiative data to the SJHS process improvement committee - COPIC and other SJHS facility team members upon request. Obtains, aggregates, and analyzes data from appropriate sources in order to facilitate process improvement initiatives consistent with Strategic Initiatives of SJHS, SJPA, SJRHC, the Revenue Cycle Team, and/or the department.
Patient/Physician/Guest/Interdepartmental Satisfaction: Understands the expectations of patients and their friends and family, physicians and staff, various departments within the organization and the SJHS executive team in order to develop a framework of customer service excellence and engage the Revenue Cycle team to meet or exceed those expectations.
Employee Development: Initiates and maintains a culture within the Revenue Cycle team that recruits and motivates high performing team members who possess and maintain an environment that consistently works to meet or exceed customer expectations, meet or exceed qualitative and quantitative departmental and revenue cycle initiatives/goals, and meet or exceed regulatory/compliance requirements. Delegates tasks and assignments to staff as appropriate in order to maximize the potential of all the staff and encourage growth in team members. Advances employee satisfaction and morale by listening and empowering.
Regulatory and Payor Compliance: Implement appropriate procedures and educate physicians, clinic staff and other personnel on state and federal laws, rules, regulations and compliance requirements, as well as private payor requirements related to the administration of Revenue Cycle functions to efficiently and effectively maintain the integrity of SJHS, SJPA, SJRHC, the Revenue Cycle Team and the Revenue Cycle department.
Financial Performance: Conduct and facilitate leadership and management activities which drive performance and optimize the physician practice revenue cycle. Demonstrate positive impact on the management of accounts receivable, cash flow, bad debt and charity expense. Provide consultative support to the VP - Revenue Management and the Senior VP-Physician Practices regarding tools, equipment, software, staffing, contract management and other Revenue Cycle factors affecting annual budgets and capital planning processes. Develop and implement effective policies, procedures and processes to meet financial goals defined through the strategic planning process (Ex: Cash collections, denials management, Days in A/R, etc.) Ensure the appropriate Revenue Cycle processes are implemented and maintained in order to meet these objectives. Ensure effective interdepartmental relationships necessary to achieve these objectives.
Liaison Role: Acts as a resource for Physician Practice Revenue Cycle processes for the St. Joseph Health System. Work with clinic managers, physicians, and office staff to identify revenue cycle problems. Research and analyze data to solve revenue problems and effect change to improve those processes. Provides leadership, direction, training when needed, other resources when needed, and access-related information to other entities within SJHS as directed by the Vice President - Revenue Management. Works with other SJHS leaders to problem solve and develop efficient and easy-to-use processes that enable stakeholders to access health care services.
Performs other duties as assigned to meet the organization`s needs.