Revenue Cycle Director

Job Announcement

Position Title: Revenue Cycle Director (ONSITE)

Department: Billing

Supervised By: COO

Location: Alpine

Status: Exempt/Salary

Posted:

Closing Date: Until Filled

Compensation: $113,429-$160,683.33/yr

Grant: N/A

Hours: Full time, Monday-Friday, 8:00AM-4:30PM.
GENERAL STATEMENT OF RESPONSIBILITIES:
Under general direction the Revenue Cycle Director is responsible for all areas of Patient Access, liaison with ancillary departments regarding the clinic. The Director will maintain a good working relationship with medical clinics to ensure Dental, Pharmacy, and Behavior Health have clear communication with the facility. Effectively interacts with patients, other health team members, and physicians while maintaining a standard of professionalism. The Director will direct and coordinate the functions and staff within developing patient billing and revenue collection policies. Timeliness, accuracy, completeness and compliance related to charge capture will support clinical departments in the clinical capture and triggering of charges for patient services provided; and the resolution of any charging pending due to provider delays or errors. The Director will oversee Billing teams to ensure Charge Description Master (CDM) output aligns with payor billing requirements, as well as organizational pricing strategies, which will also assist in achieving maximum reimbursement for the health system. This individual position is responsible for a diverse department, requiring skills in data driven decision making, process improvement/lean management, and customer relationship management.
SPECIFIC DUTIES AND RESPONSIBILITIES:

1. Supervision of Billing & Coding staff and Revenue Cycle Manager.
2. Collaborate with technical staff to assess, design, create, modify, and troubleshoot information systems to develop, support, enhance and maintain the operations, processes and performance of patient accounting and associated operations.

1. Directs and monitors compliance with all applicable regulatory requirements to include, but not limited to OIG, CMS.

1. Prepare annual department goals and objectives in collaboration with subordinates.
2. Assist patients, physicians and department personnel in resolving billing and/or collections problems.
3. Represents the department in internal and external meetings on matters involving Business Services.
4. Principles and practices of change management.
5. Project management.
6. Principles and practices of continuous quality improvement.
7. Compliance issues that relate to billing and collections of facility and professional fees.
8. Ability to manage, train, develop and motivate subordinate staff.
9. Direct, administer, coordinate, and supervise the patient business services functions.
10. Develop policies and procedures across the system for greater efficiency, reduced variation and increases patient satisfaction.
11. Optimized clinic patient revenue.
12. Responsible for oversight and leadership of system and professional fee coding and clinical documentation integrity (CDI).
13. Participates in the formulation of objectives and strategies for integrating coded clinical information to support goals for patient care, teaching, research and optimizing management of resources.
14. Serves as a coding subject matter expert for the system, serving an array of business operations and clinical committees.
15. Accountable for active daily management of Discharged Not Billes (DNB) work queues to ensure targets are consistently met.
16. Assures appropriate staffing levels and adherence to fiscal targets.
17. Develops and manages key coding and CDI performance indicators and metrics.
18. Develops and oversees a comprehensive quality assurance and productivity program for coding and CDI staff.
19. Demonstrates in depth working knowledge of ICD, CPT, MS-DRGs code classifications / groupers with the ability to analyze and trend key metrics.
20. Directs instructions and educational activities.
21. Promotes compliance with CMS, third party payers, NCDs and LCDs, coding, and billing regulations.
22. Oversee the development and coordination of ongoing CDI education for new staff, including physicians, coders, nurses, and allied health professionals.
23. Provides input coding and medical record documentation guidelines to assure compatibility and compliance with all regulatory, third party and organization policies.
24. Provides input to the direction for establishment and maintenance of documentation standards and policies and procedures related to coding and CDI activities.

1. Oversee and manages coding denial management activities. Ability to work flexible schedule may be required based on need.
2. Manage AI Technology to improve work and revenue outcome.
3. Other duties as assigned.
4. Complies with all SIHC policies & procedures.
5. Ability to work flexible schedule may be required based on need.
6. Other duties as assigned.

Supervisory Responsibilities:

1. Oversees the operations of the Billing Department, which include Billing Clerks, Coders, and Revenue Cycle Manager.
2. Leads personnel, including hiring, and performance evaluations.
3. Oversees training programs and identifies training needs.
4. Develops short- and long-term goals for the department in conjunction with the Executive C-Suite Leadership Team, Department Directors and Clinic Administrator.

QUALIFICATIONS:

Education/Experience: Bachelor's degree in business administration, Healthcare Administration, Finance, Accounting, or a related field is required. Minimum 5 years of progressive experience in managed care operations, revenue cycle, or healthcare finance. Excellent communication and interpersonal skills. Strong background in claims processing, managed care contracting, financial performance management, and team leadership. Strong analytical skills required and advanced computer skills. Proven success leading large teams and complex, cross-functional projects in a healthcare setting. Certified Professional Coder (CPC) preferred. Must be at least 18 years old.

Licenses/Certifications: A valid driver's license is required and must be maintained throughout employment. Applicant must be able to travel throughout the organization's service area including all SIHC site locations. Current certifications and/or licenses appropriate to the positions required education and profession.

Character: Applicants must have a reputation for honesty and trustworthiness. Must be responsible and able to exercise good judgment, accept administrative supervision, pay attention to detail, follow instructions, including the ability to interact effectively and communicate with people in a professional and courteous manner. Must be highly confidential and work as a team with other staff. Applicants should be sensitive to client's needs.

Skills: Strong team building, interpersonal, and organizational skills. Ability to establish and maintain effective peer relationships with coworkers within the Department, clinic-wide, and the public. Must be able to express ideas clearly, concisely, address audiences effectively, and exercise balanced judgment in evaluating situations and making decisions. Willing to be part of a team and cooperate in accomplishing department goals and objectives. Ability to prioritize, meet deadlines, take initiative, be proactive, and function in a rapidly changing environment. Ability to work with people of all social and ethnic backgrounds, resolves conflicts, negotiates situations, and facilitates consensus.

Physical and Personal Requirements: Normal clinic/office environment. Sit or stand for long periods of time. Reach, bend, climb, stoop, lift up to 25 lbs. repetitive hand movement; use and view PC. Reliable transportation and car insurance as required by the state. Travel as needed.

Compliance: Each employee plays a key role in creating a compliance culture at SIHC. Employees are expected to learn and comply with all SIHC policies and procedures. One must have the ability to understand the implications and complexities of all compliance policies. Participation in all compliance training is mandatory, and generally has a heightened awareness of policies and regulations that are specific to one's department and position. All SIHC employees are expected to report violations or suspected violations of compliance policies or regulations.

Other: Applicants must successfully pass a pre-screening tuberculin skin test or x-ray and a blood/urine drug screening test. Health must be adequate to perform all duties of the position. Applicants must complete SIHC Application and Authorization Form, both must be submitted to Human Resources prior to the close date indicated.

INDIAN PREFERENCE:

INDIAN PREFERENCE: In the filling of any SIHC job vacancy, preference may be given to qualified Native American Indians, pursuant to the Indian Preference Hiring Act, 25 USC 472, unless other laws require the filling of a vacancy without regard to Indian preference (e.g. Public Law (P.L.) 94-437, "Indian Health Care Improvement Act (IHCIA). To receive Indian Tribe ore for any SIHC position, the applicant must be enrolled, or be eligible for enrollment, as an American Indian with their Tribe, or must be certified as an American Indian from the designated Tribal Representative. Applicants claiming Indian preference must attach verification of their claim to the SIHC application, including Certification of form BIA-4432, which is available from the SIHC Human Resources Department. If verification is not or cannot be verified, the applicant will not receive Indian preference for purposes of the interview