Healthcare Revenue Cycle Director

Wipfli   •  

Fresno, CA

Industry: Accounting, Finance & Insurance

  •  

11 - 15 years

Posted 44 days ago

Responsibilities

  • Responsible for growing and developing a robust revenue cycle service line for the firm. Emphasis on acquiring new business through personal and team business development efforts as well as maintaining current client base
  • Serves as both a role model and trainer in helping new team members develop technical and professional competency
  • Planning, scoping, developing, and leading projects, including developing work plans that comply with Wipfli policies and methodologies.
  • Leading interviews with client process owners to understand current state systems, processes, and/or controls and assessing risk with minimal oversight and supervision.
  • Evaluating design and operating effectiveness of chart reviews, including efficiency, effectiveness, and mitigating controls, and procedures to remediate gaps.
  • Preparing chart review reports on findings and recommendations to senior management.
  • Reviewing deliverables, chart review work papers, and other supporting process documentation for quality.
  • Communicating strengths and weaknesses to the client or internal project management team and developing effective solutions.
  • Ensuring timely completion of assigned project phases within a provided budget.
  • Exhibiting strong ethical behavior and strong morals.
  • Developing tools necessary to perform job duties when needed
  • Developing and maintaining effective client relationships.

Qualifications

  • 10+ years in a healthcare provider industry (or relevant experience in professional services), preferably in areas such as patient financial services, reimbursement, compliance or internal audit.
  • Bachelor’s Degree in relevant discipline (e.g. Accounting, Finance, Information Technology or Business Related Field) desired.
  • Consulting experience and experience in hospitals, physician practices, RHCs and FQHCs
  • Needs strong contacts in the CA market, and business development experience.
  • Prior experience in the healthcare industry, preferably provider operations including hospitals, physician practices and ancillary services.
  • Understanding of revenue cycle operations and revenue cycle accounting principles.
  • Strong knowledge in CMS requirements for reimbursement
  • Knowledge of the Health Insurance Portability and Accountability Act (HIPAA), Stark, Anti-kickback and other industry-relevant compliance requirements.
  • Provider billing and reimbursement, including revenue recognition and accounts receivable management
  • General knowledge of healthcare provider operations, including hospitals, physician practices, home health, hospice, skilled nursing
  • Relevant regulatory knowledge within the industry including, but not limited to: CMS, OIG, HIPAA, ACA etc.
  • Key healthcare provider processes including, but not limited to: charge capture, billing, collections, compliance, patient access, medical records, payer contracts, physician relationships, financial operations, foundation, etc.
  • Project management, supervisory, leadership, and mentoring experience.
  • Ability to interpret payer contracts
  • Strong analytical and problem-solving skills.
  • Advanced verbal and written communication skills including documentation of findings and recommendations.
  • Strong listening skills to discern the best course of action for our clients.
  • Understanding of commonly used internal control concepts
  • Knowledge of chart review processes and methodologies, including developing process flows.
  • Travel throughout the month frequently required based upon client requests/commitments. Travel may include suburban, regional, or out of state locations.

2018-2561