Director Revenue Cycle

Fort HealthCare is a patient-centered hospital and healthcare system serving individuals, businesses and families in Jefferson, Dane, and Walworth Counties. We are seeking a Director of Revenue Cycle to join our leadership team.

The Director of Revenue Cycle oversees the revenue cycle operations of the organization including patient access and registration, coding and billing services, provider and payer credentialing, collections, cash accounting, and patient accounts' auditing to ensure core revenue cycle processes for protecting the assets of the organization. The Director also oversees the functions of the Health Information Management Department which coordinates the release of medical records and provides coding support which directly impacts all billing operations. The secondary function of the Director is to serve as the organization's HIPAA Privacy Officer and Assistant Compliance Officer.

Responsibilities of this position include:

Directs and provides leadership for revenue cycle functions including registration, patient accounts and billing and financial counseling as well as all accounting functions including accounts payable, customer service and patient accounts auditing, cost and general accounting, financial statement preparation, audit, operating and capital budget, cash management, financial analysis and decision support.

Participates in organization-wide strategic planning on an annual basis, monitors identified goals for each department and reports on improvements quarterly. Looks for process improvements and efficiencies through new technologies while reducing costs.

Assists Business Office Manager and HIM Manager in developing annual departmental goals and objectives and meets with them on a regular basis to ensure the goals and objectives are meeting the planned timelines.

Reviews and evaluates organization's departmental policies and procedures to ensure compliance with HIPAA, government and payer contractual obligations; recommends changes as necessary to ensure that organization objectives, compliance and cost effectiveness are maximized.

Provide leadership in developing best-practice revenue cycle operations, coding accuracy and HIPAA compliance; develops and conducts annual Fraud & Abuse training for organization and ensures fraud training attestations for Medicare Advantage Plans and the ACO.

Selects, hires, oversees the training of employees and supervises employees.

**Develops organization's Compliance Plan in conjunction with the Compliance Officer.

Participates on committees with QIC and others that interact with the organization's managed care payers and the ACO to evaluate the impact of the payers' quality metrics on reimbursements.

Reviews operational and financial data for the purpose of developing various strategies to maximize organizational cash inflow. Utilizes Oracle Health dashboards and third-party data to analyze this data.

Reviews and monitors internal audit procedures as specified by the SVP/CFO and audit workpapers required by external audit firms.

Oversees credentialing process to ensure providers are credentialed with Medicare, Medicaid and commercial payers; acts as Authorized Official for the organization in the Medicare PECOS system.

Represents Revenue Cycle, Privacy Officer/Asst. Compliance Officer in various organizational committees as needed, e.g., JQIC, Q&VBC, PCC, ISPC, EAC, MCEC, CORE, and other ad hoc meetings, etc.

Review non-payer contracts and Business Associate Agreements for compliance and integrity standards; send to SVP/CFO for approvals.

Investigate potential HIPAA violations/breaches, conduct staff interviews, monitor P2 Sentinel, maintain logs, coordinate with Compliance Officer and legal counsel as needed.

Requirements of this position include:

Bachelors degree required

2 years accounting experience required

5 years of experience, preferably in a health care setting preferred

Background in health care compliance, HIPAA preferred

RN license preferred

Fort HealthCare is proud to be named a 14-time award winner of the Milwaukee Journal Sentinel Top Workplace award for Southeastern Wisconsin, a 4-time award winner of the USA Top Workplaces award, and a 2-time winner of their Top Workplaces Culture Excellence award for Purpose & Values.

In addition, Fort HealthCare is proud to be awarded the inaugural 2024 Wisconsin Hospital Association (WHA) Hospital Mentorship and Quality Champion Award. The Hospital Mentorship and Quality Champion award recognizes a hospital for demonstrating mentoring relationships and engagement through active participation, collaboration and the sharing of tools and resources with other hospitals.

Our Mission Statement is our daily guide to provide the best health care possible. We promote it widely for all we serve to read, understand and to help our public hold us accountable for the promises we make.

Our Mission Statement - Improve the Health and Well-being of Our Community

Our Vision Statement provides each of us at Fort HealthCare with a goal. It is our motivation to improve constantly upon the level of care we provide, and the quality of services delivered.

Our Vision - Be the Healthiest Community in Wisconsin.

Benefits:

Competitive pay

401(k) with employer match

Generous PTO Plan

Daycare

Dental insurance

Disability insurance

Flexible Spending

Health Insurance

Comprehensive Wellness Plan

Life Insurance

Pharmacy Discount

Tuition Assistance

Vision and Dental Insurance

Employee Assistance Program

Free Parking