Orthopedic Specialists
Director of Revenue Cycle
Orthopedic Specialists, Fort Myers, Florida, United States, 33916
Join Orthopedic Specialists of SW Florida as Director of Revenue Cycle Operations, where you will play a crucial role in overseeing and optimizing the operational aspects of our Billing Department. With a focus on the oversight of the revenue cycle to maximize revenue utilizing the most innovative and effective processes
About OSSWF:
Orthopedic Specialists of SW Florida has been a cornerstone of orthopedic care in the Fort Myers area for over 23 years. Our practice boasts a team of 16 fellowship-trained orthopedic surgeons specializing in various subspecialities. We are committed to excellence and continued growth, offering comprehensive services including onsite Physical Therapy/Occupational Therapy, MRI, and digital X-ray. We prioritize patient care and strive for the highest standards of service.
Orthopedic Specialists of SW Florida's state-of-the-art, 60,000 square-foot facility incorporates the latest in leading-edge technology in order to provide optimal care for patients who have bone, joint, muscle and spine problems. Our office includes five Centers of Excellence and a full Physical Therapy and Occupational/Hand Therapy division, which work in close coordination with our physicians to provide non-operative, preoperative, post-operative and preventive care.
Responsibilities:
The Director, Revenue Cycle Operations will be responsible for managing Orthopedic Specialist of SW Florida medical billing, insurance and patient collections and related support activitiesInitial priorities will include developing the strategic vision, selecting third-party billing partners and executing billing initiativesFuture priorities will include fine-tuning the operating activities to optimize revenue collections as well as develop key service and support metricsIn this role, the Director, Revenue Cycle Operations will work closely with executives, directors, physicians, and managers as well as third partiesHands-on management of all billing programs, systems, processes, and third-party vendors to ensure accurate, timely and well-controlled activities related to billing, collections, education, and supportPrepares daily, weekly and monthly RCM reporting metrics to remediate any items outside established KPI including status report of projectsEffectively implement denial management reduction through process improvements, coordinating direct or indirectly, with internal team and offices to improve workflows and provide training and educationMaintain understanding and communicates payor policy changes across the marketResponsible for Worker's compensation relations and statutory changesPromote positive attorney relations, stay current with PIP laws, and negotiate personal injury case settlementsMeet with payor representatives for timely remediation of large denial or underpayment projectsFormulate and execute policies and procedures to ensure the billing workflow is highly effectiveDaily reviews of the following programs: Incoming claim/denial volumes, daily billing, rejections, evaluate clean claim rates, and team workflowPresents first-line negotiation of payer contracts on an annual basis to the CEO and CFOEvaluate and communicate fee schedule changes, or changes that affect payments annuallyAnnual charge master analysis and implementationDevelops quality control program to meet the company's quality initiativesEnsure productivity goals are monitored and quickly re-mediates barriers to achieving those goals at the individual and/or team levelCounsels and disciplines employees in accordance with department goals and policiesMaintain compliance with directives from all regulatory agencies and third partiesNew provider onboarding, train on billing processes, also working in coordination with credentialing supervisorEnsure staff compliance with coding, PCI, insurance company policy changesCollaborate with other departments to maximize training and efficiencyMaintain department compliance with state and federal regulationsRequired to attend all executive meetingsAttend conferences pertaining to orthopedics or billing at the discretion of the CFOMinimum Requirements (education, experience, special skills and licenses or certifications required):
10+ years of managerial experience in healthcare revenue management cycle roles with experience in all phases of the revenue cycle management. Orthopedic experience preferred.Experience with Modernizing Medicine EMR and billing system preferredExperience with a large group, growing healthcare organization supportExtensive knowledge of patient registration, coding, billing, regulatory requirements, billing compliance, business operations, financial systems and financial reportingStrong work ethic, attention to detail, knowledge of the claims process, coding, billing, collections and credentialingBenefits:
Competitive PayGenerous PTO Allowance6 Paid Holidays401KAffordable Medical, Dental, & Vision Insurance and more!Additional Comments:
Drug Screening is requiredOrthopedic Specialist of SW FL. participates in E-VerifyCriminal background screening mandatory"Applicants have rights under Federal Employment Laws" Family and Medical Leave Act (FMLA) Poster; Equal Employment Opportunity (EEO) Poster; and Employee Polygraph Protection Act (EPPA) Poster.
Orthopedic Specialist of SW Florida is an Equal Opportunity Employer & Drug Free Workplace. 14601 Hope Center Loop, Fort Myers, Fl. 33912
About OSSWF:
Orthopedic Specialists of SW Florida has been a cornerstone of orthopedic care in the Fort Myers area for over 23 years. Our practice boasts a team of 16 fellowship-trained orthopedic surgeons specializing in various subspecialities. We are committed to excellence and continued growth, offering comprehensive services including onsite Physical Therapy/Occupational Therapy, MRI, and digital X-ray. We prioritize patient care and strive for the highest standards of service.
Orthopedic Specialists of SW Florida's state-of-the-art, 60,000 square-foot facility incorporates the latest in leading-edge technology in order to provide optimal care for patients who have bone, joint, muscle and spine problems. Our office includes five Centers of Excellence and a full Physical Therapy and Occupational/Hand Therapy division, which work in close coordination with our physicians to provide non-operative, preoperative, post-operative and preventive care.
Responsibilities:
The Director, Revenue Cycle Operations will be responsible for managing Orthopedic Specialist of SW Florida medical billing, insurance and patient collections and related support activitiesInitial priorities will include developing the strategic vision, selecting third-party billing partners and executing billing initiativesFuture priorities will include fine-tuning the operating activities to optimize revenue collections as well as develop key service and support metricsIn this role, the Director, Revenue Cycle Operations will work closely with executives, directors, physicians, and managers as well as third partiesHands-on management of all billing programs, systems, processes, and third-party vendors to ensure accurate, timely and well-controlled activities related to billing, collections, education, and supportPrepares daily, weekly and monthly RCM reporting metrics to remediate any items outside established KPI including status report of projectsEffectively implement denial management reduction through process improvements, coordinating direct or indirectly, with internal team and offices to improve workflows and provide training and educationMaintain understanding and communicates payor policy changes across the marketResponsible for Worker's compensation relations and statutory changesPromote positive attorney relations, stay current with PIP laws, and negotiate personal injury case settlementsMeet with payor representatives for timely remediation of large denial or underpayment projectsFormulate and execute policies and procedures to ensure the billing workflow is highly effectiveDaily reviews of the following programs: Incoming claim/denial volumes, daily billing, rejections, evaluate clean claim rates, and team workflowPresents first-line negotiation of payer contracts on an annual basis to the CEO and CFOEvaluate and communicate fee schedule changes, or changes that affect payments annuallyAnnual charge master analysis and implementationDevelops quality control program to meet the company's quality initiativesEnsure productivity goals are monitored and quickly re-mediates barriers to achieving those goals at the individual and/or team levelCounsels and disciplines employees in accordance with department goals and policiesMaintain compliance with directives from all regulatory agencies and third partiesNew provider onboarding, train on billing processes, also working in coordination with credentialing supervisorEnsure staff compliance with coding, PCI, insurance company policy changesCollaborate with other departments to maximize training and efficiencyMaintain department compliance with state and federal regulationsRequired to attend all executive meetingsAttend conferences pertaining to orthopedics or billing at the discretion of the CFOMinimum Requirements (education, experience, special skills and licenses or certifications required):
10+ years of managerial experience in healthcare revenue management cycle roles with experience in all phases of the revenue cycle management. Orthopedic experience preferred.Experience with Modernizing Medicine EMR and billing system preferredExperience with a large group, growing healthcare organization supportExtensive knowledge of patient registration, coding, billing, regulatory requirements, billing compliance, business operations, financial systems and financial reportingStrong work ethic, attention to detail, knowledge of the claims process, coding, billing, collections and credentialingBenefits:
Competitive PayGenerous PTO Allowance6 Paid Holidays401KAffordable Medical, Dental, & Vision Insurance and more!Additional Comments:
Drug Screening is requiredOrthopedic Specialist of SW FL. participates in E-VerifyCriminal background screening mandatory"Applicants have rights under Federal Employment Laws" Family and Medical Leave Act (FMLA) Poster; Equal Employment Opportunity (EEO) Poster; and Employee Polygraph Protection Act (EPPA) Poster.
Orthopedic Specialist of SW Florida is an Equal Opportunity Employer & Drug Free Workplace. 14601 Hope Center Loop, Fort Myers, Fl. 33912