Revenue Cycle Management - Director of Revenue Cycle Management

Description

Lake Butler Hospital is a critical access hospital in North Florida providing 24-hour emergency services, inpatient hospitalization, swing bed program, rehabilitation services, outpatient laboratory, and outpatient radiology (X-ray, ultrasound, and CT Scan) services to Union County and the surrounding counties. We are devoted to providing all members of our community with premier-quality health care in a compassionate and inviting environment.

We are looking for a knowledgeable and experienced Director of Revenue Cycle Management to join our team!

For full-time employees, we offer medical benefits, paid time off, 401k after one year of service, discounts at Willow Cafe and more!

Job Summary:

Responsible for maintaining and enhancing the revenue cycle process by effectively managing all aspects of the hospital’s revenue cycle areas to include, registration, scheduling, collections, billing, data entry, medical records and coding. This responsibility includes modifying and maintaining policies; continually seeking mechanisms to streamline and automate processes; enhancing net cash collections, reducing costs and building and maintaining external and internal customer relationships to ensure that the Hospital’s financial and customer service goals are optimally accomplished.

Duties and Responsibilities:

1. Key member and leader of the Revenue Cycle process, with responsibility for driving continuous improvement and effectiveness.

2. Coordination and supervision of all coding, medical record releases, patient registration, claims processing and collections of self-pay and third-party payer accounts and staying aware of all current third-party reimbursement procedures. To include but not limited to Medicare, Medicare HMO, Medicaid, Medicaid HMO, Blue Cross/Blue Shield, AVMED, United Healthcare, Workers Compensation, Commercial and other Managed Care Insurance.

3. Maintains Accounts Receivables so that the hospital’s cash position is not impaired through the management and reduction of AR Days in Revenues and increase in Collection % to Revenues.

4. Supervises Cash Collections to ensure proper application and security of collection funds and assets.

5. Effectively presents information and responds to questions from other department heads, staff members, patients, patient’s families, and the general public.

6. Establish and implement controls to ensure appropriate charging, claims submission, and payment cycles.

7. Establish appropriate procedures for follow-up to third party approvals, billing, and collection on overdue accounts.

8. Work closely with HIM Staff, Case Management Director, Chief Nursing Officer, third party payers, practitioners, and patients to ensure activities of each will not impair the cash position of the hospital.

9. Investigate all overpayments from patients and third-party payers, government agencies and patients and authorize refunds in a timely manner.

10. Responsible for ensuring proper maintenance, security, and retention of records in compliance with hospital policies and procedures; coordinates external and internal audits of charges and claims processing/collections.

Health Information Management Duties and Responsibilities

1. Oversee day to day operation of department as it applies to staffing and management, transcription, chart organization/filing, diagnostic coding, ROI and customer service.
2. Responsible for supervising, evaluating, training, interviewing, hiring, and termination of all H.I.M Personnel.
3. Responsible for staff scheduling i.e., time off requests, time and attendance processing.
4. AHCA point of contact for annual survey on all matters related to HIM Department and quarterly reporting.
5. Maintain control of electronic and paper records/ ensures compliance to all HIPAA policies and procedures specific to record security, privacy, release, accounting of disclosures, retention and destruction.
6. Monitors and assures correct coding of charts.
7. Monitors and assures clinician compliance on chart completion.
8. Thorough monitoring of chart completion and coding, assures that Business Office can bill timely.
9. Responsible for reviewing, updating, and creating any new H.I.M. policies and procedures as needed to meet all federal/state licensure/accreditation standards.
10. Maintain statistics for H.I.M. Performance improvement projects.

General Duties:

1. Ensures positive guest relations by demonstrating a welcoming, caring, and helpful attitude to all patients and visitors of LBH and enforces this attitude among other staff.
2. Functions as an effective team member by maintaining positive intra-and interdepartmental relationships.
3. Protects patients’ rights by maintaining confidentiality of personal and financial information in compliance with HIPAA policies
4. Attends and or completes mandatory annual education to include, but not limited to infection control, safety, risk management, etc.
5. Complies with hospital policies and procedures.
6. Contributes to the overall success of Lake Butler Hospital by performing all other duties as assigned.
7. Serves on committees as requested by Administration.
8. Always presents a professional appearance and attitude.

Patient Accounts, Revenue Cycle, Business Office, Billing, Patient Financial Services

Lake Butler, Starke, Gainesville, Alachua, High Springs, Macclenny, Glen Saint Mary, Lake City, Keystone Heights, Baldwin, Jacksonville, Middleburg, Orange Park

Requirements

Education:

Associate Degree in Accounting/Business Administration or related field.

Bachelor’s Degree (B.A. or B.S.) in Business/Finance/Health Care Administration.

Experience:

At least 5 years of experience and additional training in management of hospital patient accounts department Registration, Collections, and Insurance experience required.  Previous experience as a Revenue Cycle manager preferred.

Skills:

Ability to read, analyze, and interpret various business applications, technical procedures and government regulations. Strong grammar skills, written and oral. Computer skills, including all Microsoft Office software to include Word and Excel. Effective oral and written communication skills. Attention to detail and good record-keeping skills a must.

Knowledge:

Strong knowledge of hospital and physician billings and insurance reimbursement, to include Medicare, Medicaid and Workers Compensation regulations, and fair debt collections act, understanding of the accounts receivable system and strong analytical skills to evaluate and interpret the impact of all internal and external forces as they relate to the collections process. Knowledge of computer operations, spreadsheet and word processing programs. Knowledge of medical terminology & understand the benefits for all insurances.

Abilities:

Strong management and communications skills. Ability to work well under high pressure situations, is results oriented and a self-starter. Commitment to the continuous improvement and financial success of the hospital. Strong organizational skills and policy and procedure development. Effectiveness in achieving organizational and departmental objectives. Displays responsibility to confidential aspects of medical/financial information. Pleasant attitude in dealing with the public and various levels of staff.

PM22