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Human Resources

 

Important Applications Instructions:

Please complete this application in entirety by providing all of your work experience, education and certifications/

 

license.  You will be unable to edit/add/change your application once it is submitted.

 

Job Requisition ID:

R00044212

Job Category:

Professional and Technical

Organization:

Revenue Cycle

Location/s:

Central Billing Office-Clinton

Job Title:

Senior Director - Revenue Cycle Financial Services

Job Summary:

Responsible for overall management oversight, direction and planning for the effective functioning of all daily operations of professional and hospital revenue cycle comprised of, claims submission, claims follow up, payment posting, credits, and charge description master. These functions include, but are not limited to: manage workflows and processes for each area in working claim edits, properly billing claims, proper identification and follow up on payment denials, payment posting, and processing credit/refunds and updating the charge description master to stay compliant with current regulations. The Executive Director conducts ongoing EPIC system optimizations and departmental process improvement reviews to ensure efficiency of departmental operations. The Executive Director also acts as a liaison between clinical and operational leadership in order to meet the organization’s strategic goals, missions, and customer requirements. This position is accountable to the Chief Revenue Cycle Officer and must possess exceptional communication and analytical skills.

Education & Experience

Education and Experience Required:

 

Bachelor’s degree and seven (7) years revenue cycle experience, three (3) years of which must be in a supervisory role 

 

Certifications, Licenses, or Registrations Required:

 

N/A

 

Preferred Qualifications:

 

Management level position in a complex health system or insurance environment. EPIC experience and or certifications. Certified Practice Administrator through American Association of Healthcare Administration Management (AAHAM), Certified Healthcare Financial Professional through Healthcare Financial Management Association, (HFMA), or Certified Cycle Representative (CRCR) or Certified Revenue Cycle Specialist (CRCS) through Healthcare Financial Management Association (HFMA).

 

Knowledge, Skills & Abilities

Knowledge, Skills, and Abilities:

 

Must demonstrate a thorough understanding of the full Revenue Cycle with up-to-date knowledge of the industry. Experience recruiting, retaining, & developing high-performing teams is needed.

 

Knowledge of medical practice and hospital financial & clinical operations is needed, including billing, reimbursement, and provider enrollment requirements for federal & state programs (Medicare, Medicaid) as well as current insurance industry standards. Must be familiar with claims submission and reimbursement requirements for numerous private and government insurance plan types, including preferred provider organizations, health maintenance organizations, third-party administrators, regional physician office plans, point of service plans, etc. Advanced written & verbal communication skills are needed as well as an ability to lead meetings & presentations to management/senior leadership. The ability to delegate assignments to managers/staff; instruct and monitor progress, & review work. Excellent customer service skills are required along with the ability to deal with difficult situations with tact & diplomacy. Superior ability to handle multiple priorities while maintaining a ‘team’ environment is critical. A strong focus on customer satisfaction & service orientation is imperative.

 

Responsibilities:

 

Directs and coordinates the daily operations for all professional and hospital revenue cycle activities.  Ensures that operations are aligned with the strategic goals and objectives that meet or exceeds peer group benchmarks.

Establishes on an annual basis and in conjunction with the Chief Revenue Cycle Officer, realistic goals and budgets for the associated areas of responsibility; ensures adherence to the cost center budgets. Acknowledges and supports the organizations defined goals and approach to patient care; exemplifies superior customer service skills, attends regular training sessions and management classes to improve patient and customer communications.

Leads multiple teams and assume ultimate accountability for high-quality deliverables through direct and indirect supervision of all Professional and Hospital Revenue Cycle personnel. Collaborates with training and performance improvement team to identify and develop best practices.

Maintains current knowledge of and complies with established policies and procedures including patient confidentiality/patient rights, government, and insurance and third-party payor regulations.  Interprets and applies government and managed care billing requirements. 

Develops and is accountable to department performance metrics and produces measurement reports and tools. 

Prepares, secures approval of, and oversees implementation of policies and procedures to meet agreed upon performance standards. Enforces organizational policies and procedures to ensure quality customer service, high staff productivity, appropriate cost controls and effective operations.

Responsible for working across the organization, creating and updating revenue cycle systems and workflows that will streamline activities among both the hospital and the physician staff. Evaluating and reengineering processes to optimize revenue cycle performance.

Acts as a liaison with other organizational stakeholders designing and implementing effective Professional and Hospital Revenue Cycle systems and workflows to streamline activities among internal stakeholders.  Evaluates and reengineers processes to optimize revenue cycle performance.

The duties listed are general in nature and are examples of the duties and responsibilities performed and are not meant to be construed as exclusive or all inclusive. Management retains the right to add or change duties at any time.

Environmental and Physical Demands:

 

Requires no exposure to unpleasant or disagreeable physical environment such as high noise level and exposure to heat and cold, no handling or working with potentially dangerous equipment, occasional working hours beyond regularly scheduled  hours, occasional travelling to offsite locations, frequent activities subject to significant volume changes of a seasonal/clinical nature, constant work produced is subject to precise measures of quantity and quality, occasional bending, occasional lifting/carrying up to 10 pounds, occasional lifting/carrying up to 25 pounds, no lifting/carrying up to 50 pounds, no lifting/carrying up to 75 pounds, no lifting/carrying up to100 pounds, no lifting/carrying 100 pounds or more, occasional climbing, no crawling, occasional crouching/stooping, occasional driving, no kneeling, occasional pushing/pulling, frequent reaching, frequent sitting, frequent standing, occasional twisting, and frequent walking.  (Occasional-up to 20%, frequent-from 21% to 50%, constant-51% or more)

 

Time Type:

Full time

FLSA Designation/Job Exempt:

Yes

Pay Class:

Salary

FTE %:

100

Work Shift:

Day