Director of Revenue Cycle - FT

POSITION PURPOSE:

Responsible for coordinating billing processes of the revenue cycle; for managing and controlling all phases of the hospital’s accounts receivable operation in order to ensure the institution realizes a maximum cash flow and money position; accurate and timely billings and collections from patients and third-party payers.

ESSENTIAL FUNCTIONS AND BASIC DUTIES:

Supervisory-Specific Performance Expectations, Duties, and Responsibilities:

• Demonstrates 100% commitment to high performance in accordance with the CHOICE values of MRH and represents the organization in a positive and professional manner.
• Carries out managerial responsibility of the department through effective communication and in accordance with the employee handbook, policies, procedures, and applicable laws, including interviewing, hiring, orienting, training, planning, assigning, and directing work; establishing deadlines; scheduling; timekeeping; providing continuous, overall performance feedback and evaluation, including appropriate documentation supporting employee performance assessment; rewarding and disciplining employees; addressing complaints, conducting departmental investigations in collaboration with HR and Risk Management leadership, and effectively resolving problems.
• Plans, coordinates, assigns, and monitors department performance and coaches, counsels, mentors, trains, and advises employees in the department for the dual goals of meeting department, organizational, and employee career development goals.
• Interprets, develops, communicates, updates, and/or monitors policies, procedures, and standards for the department, in relation to applicable laws and organizational goals.
• Oversees the preparation of the department budget and manages department contracts, including providing accounting of expenditures; preparing and submitting requests/purchase requests for operating, personnel, and capital budget; providing and presenting financial information, data, and history to justify requests to aid in discussions; negotiating contracts; monitoring the work of contractors/vendors and assuring that work is done in compliance with contract specifications; and participating in related meetings. Coordinates with the Chief Financial Officer (CFO) and Human Resources Department on personnel budget matters.
• Plans and implements short-term, long-term, or annual goals, objectives, and strategies for the department, projects, or programs to ensure efficient organization and completion of work.
• Ensures quality standards and compliance with applicable laws and regulations are maintained.
• Maintains and upgrades professional knowledge, skills, and development by attending seminars and training programs and reading trade and professional journals and publications.
• May serve as a liaison and/or member of various committees, boards, and/or teams and collaborates, persuades, presents reports to, and negotiates with others outside own work area to coordinate efforts and maintain cooperative and efficient relations.
• Attends and participates in monthly management meetings.

Position-Specific Performance Expectations, Duties, and Responsibilities:

• Implement and sustain best practices for all Revenue Cycle activities for hospital, medical clinics, and EMS locations. Work closely with all departments within the Revenue Cycle to ensure processes are best practice; develop metrics based on best practice and measure improvement against metrics.
• Working with CFO to implement training & education programs as well as financial reporting dashboards in relation to the Revenue Cycle to ensure the organization can measure key performance indicators (KPIs) and meet benchmarks.
• Oversee roles and responsibilities of direct reports, Business Office Manager and Revenue Cycle Auditor, as well as all staff reporting up through these roles.
• Responsible for direct oversite for organization’s billing vendors, Medicaid eligibility program, banking and online payment services, and follow up collection companies. Maintain annual evaluations of these vendors to ensure effectiveness.
• Ensure timely management of old and/or uncollectible accounts including bad debt with regular reviews, appropriate write-offs, and implementation of strategies to minimize future occurrences.
• Work closely with IT Director to maintain online Medicare portal and data
• Work directly with host facility’s EPIC technical support for all issues related to Revenue Cycle, ensuring that projects and tickets are accurately completed, thoroughly tested, and validated before moving into production.
• Monitors the unbilled and uncoded accounts, working closely with HIM Manager to support minimizing these accounts.
• Manages all complaints from patients that require a charge, billing, or payment review, presenting chart to the proper person for review & following the account through until completion.
• Responsible for monitoring new regulations involving the Revenue Cycle, developing processes or policies to manage these regulations and ensure compliance.
• Establishes and maintains control for all cash collected and posted in the Patient Accounting
• Establishes policies and procedures for eligibility and benefit verifications, time of service collection requirements, and financial assistance processes.
• Ensures policies and procedures are developed related to patient reception, insurance processing, Medicare Secondary Payer (MSP) quality assurance and compliance.
• Lead, mentor, and develop revenue cycle staff, fostering a culture of accountability, continuous improvement, and professional growth.
• Provide training and feedback on competencies for performance reviews for all employees within the department. Assure all department evaluations are performed timely.
• Oversee contract management process, ensuring all payer contracts are accurately maintained, tracked, and reviewed frequently for compliance with organizational policies and regulatory requirements.
• Identify opportunities within Revenue Cycle Management and make recommendations to management for improving processes and performance.
• Assist CFO with annual CDM pricing strategies
• Manage and maintain vendor contracts related to revenue cycle operations, ensuring compliance with terms and conditions, tracking contract renewals, and evaluating vendor performance to support operational efficiency and cost-effectiveness.
• Member of the RAC team. Must have general understanding of RAC program. The team establishes process and procedures to manage audits, and verify Work closely with Compliance Officer on Revenue Cycle related issues as requested.
• Conducts internal audits pertaining to denials, workqueue management, etc. Review and evaluate Make recommendations based on these results to improve revenue, workflows and/or compliance regulations.
• Responsible for statistical information needed to complete annual reporting for Medicare Cost Report, CHASE, DSH, Financial Audit, Hospital Discounted Care, and others as needed.
• Works conjunctively with the HIM Manager to maintain the ChargeMaster updates and follow up on department questions.
• Attends in-services, participate in manager and daily alignment
• Review monthly manager operating report (MOR), approve bi-weekly timesheets, and complete the annual budget for Revenue Cycle.
• Serve as a member of the Finance Committee and other committees as requested by
• Demonstrates a professional, positive and caring attitude while promoting excellent customer service.
• Reviews all safety
• Performs other duties as assigned.

Organization-Specific Performance Expectations, Duties, and Responsibilities:

• Demonstrates 100% commitment to performance in accordance with the CHOICE values of MRH and representing the organization in a positive and professional manner.
• Establishes and maintains effective verbal and written communication and good working relationships with all patients, staff, and vendors.
• Adheres to MRH attire/dress code per policies and procedures.
• Utilizes initiative; strives to maintain a steady level of productivity; self-motivated; and manages activity and time.
• Completes annual education, training, in-service, and licensure/certification requirements; and attends departmental and organizational staff meetings or reads meeting minutes.
• Maintains patient confidentiality at all times.
• Reports to work on time as scheduled; completes work within designated timeframes.
• Actively participates in departmental and organizational performance improvement and continuous quality improvement activities.
• Strives to uphold regulatory requirements to ensure continual compliance with departmental, hospital, state, and federal regulations and policies.
• Follows policies and procedures for infection control, safety, and risk management to ensure a safe environment for patients, the public, and staff.

Qualifications

Minimum Requirements:

• Must be at least 16 years of age (21 for driving positions with a valid driver’s license).
• Must be able to legally work in the United States.
• Must be able to pass a background check.
• Must be able to pass a drug screen and breath alcohol test (if applicable).
• Must complete employee health meeting

Required Education/Licensure/Certification:

• Certification related to Billing or Coding preferred (CPC, CPB, CRCP, etc.)

Preferred Experience:                                                         

• Bachelor’s Degree in Healthcare Administration, Business, Finance, or a related field preferred.
• Three years of direct healthcare Revenue Cycle experience required, Critical Access Hospital and Rural Healthcare Clinic experience preferred.
• Revenue Cycle Management experience preferred.
• One year working in EPIC HB and PB platforms preferred.

Position Classification:  Exempt 

Compensation Range:  $105,124 - $157,686.

Benefits:  Medical, Dental, Life, Retirement, Paid Time Off

Salary : $105,124 - $157,686