REVENUE CYCLE DIRECTOR

Impekkable, an award-winning healthcare consulting and hospital management firm is looking for a Revenue Cycle Director to join a critical access hospital in northwestern Washington.
We seek an individual with comprehensive knowledge of Revenue Cycle Management, encompassing both front-end and back-end processes. We are looking for a Revenue Cycle Management Expert!

• Full-time, permanent
• Onsite in Coupeville, WA

The revenue cycle encompasses all administrative and clinical activities that facilitate the capture, management, and collection of patient service revenue. The Revenue Cycle Director plays a pivotal role in optimizing and sustaining an effective revenue cycle process by coordinating efforts across various departments and is responsible for the analysis, design, development, and execution of revenue cycle initiatives related to improving revenue and cash collections, reducing cycle times and costs, and increasing practice efficiencies. These functional areas act interdependently during patient interactions, contributing critical information required for clinical service, and procuring payments. The Revenue Cycle Director consequently concentrates resources on improving core clinical care delivery and protecting the assets of the organization.

This individual will also be tasked with overseeing and enhancing employee productivity, as well as facilitating ongoing improvements to essential revenue cycle metrics. This includes optimizing all facets of the billing cycle and developing strategies aimed at increasing revenue. The Revenue Cycle Director is required to exhibit, through strategic planning and implementation, a uniform standard of excellence that all departmental activities must adhere to. This standard should be founded on the establishment and preservation of a clear purpose, emphasizing ongoing enhancement within the Director’s scope of influence, and ensuring the delivery of superior quality service.

ESSENTIAL FUNCTIONS

• Oversee and support the daily operations of all PFS functions, including billing, follow-up and collections, cash posting and all Patient Access areas (Main Registration and ED Registration).
• Work closely with other departments (HIM, Case Management, Information Technology, Nursing, and Ancillary departments) to streamline procedures that will help ensure correct billing to patients and payers in a timely manner, thereby expediting hospital receivables.
• Oversee work schedule and direct changes in priorities and schedules as needed to assure work is completed in an efficient and timely manner and to improve the department’s performance and service.
• Direct the selection, supervision and evaluation of staff. Ensure performance evaluations are conducted in a timely manner according to hospital policy and initiate disciplinary actions as warranted. Resolve grievances and other sensitive personnel matters.
• Oversee orientation and continuing education for all staff. Ensure mandatory and relevant training is provided to staff in a timely manner.
• Implement a Quality Assurance program for PFS functions and monitor staff and team performance, making changes, when required, to support accurate billing to payers and patients in a timely manner and compliance with laws and department procedures.
• Establish and maintain departmental policies and procedures. Communicate relevant information to other hospital departments. Establish controls and review mechanisms to ensure procedures are being followed correctly. Recommend policy changes to the Chief Financial Officer.
• Collaborate with Billing, Collection, and Patient Access Managers to plan, organize, and deliver regular staff meetings for the department.
• Assist with the development of budgets and monitoring of department operations to achieve goals within budget.
• Respond personally to concerns and/or complaints expressed by patients, visitors, hospital staff, and physicians in effort to support optimal operations and excellent customer service.
• Ensure compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers.
• Maintain appropriate internal controls for the safeguarding of cash.
• Follow and monitor compliance with hospital policies and standards.
• Develop, redesign, and monitor key performance indicators including payer mix, A/R, collection rates, adjustments, bad debt write off, estimated collections, appeal success rates, and other requested parameters.
• Maintain extensive knowledge of revenue cycle and regulatory requirements associated with governmental, managed care, and commercial payers.
• Serve as the subject-matter expert on regulatory, compliance, and legal requirements associated with medical billing and CMS. Ensure compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers.
• Develop and maintain internal controls to target revenue recovery throughout the organization by identifying charge capture, coding, and reimbursement problems, then recommending/implementing solutions.
• Monitor A/R effectively and ensure aging categories are within established goals and national benchmarks.
• Responsible for maximizing the collection of medical services payments and reimbursements from patients, insurance carriers, financial aide, and guarantors.
• In conjunction with operations, review and enhance insurance verification, coding review, billing, collection, and payment posting processes for efficiency and best practices; ensure systems are fully functional and maximized and recommend new processes to improve current workflow.
• Monitor daily productions of claims, denials, and appeals.
• Analyze claims, utilization, and medical cost data.
• Monitor aged accounts and verify appropriate collections procedures are being followed.
• Review, monitor and recommend updates to the Clinic’s fee schedule to maintain fees at levels that maximize reimbursement.
• Ensure compliance with relevant federal, state, and payor-specific billing requirements.
• Regularly provide upper management with revenue cycle status including reports, metrics, and presentation.
• Ensure staff is educated on new technology, goals, and contracts.
• Establish a regularly scheduled revenue cycle meeting to discuss strategies and ensure everyone is educated on the direction of the department.
• Work with Managed Care vendors in identifying any payer relation issues or contracts that need to be renegotiated or negotiated for the first time.
• Any and all other projects, goals, issues surrounding the revenue cycle, conflicts or concerns as directed or indicated by Administration.

EDUCATION & QUALIFICATIONS

• Bachelor’s degree in Healthcare Administration, Business, Accounting, Finance or related field.
• Minimum of 5 years of management-level experience in hospital revenue cycle with expertise in billing and collections.
• Masters in hospital or business administration, accounting, finance, or related field and closely related clinical discipline preferred.
• Thorough knowledge of patient financial services (PFS) processes and standards related to billing, collections, and cash posting. General knowledge of patient registration, finance, and data processing.
• Knowledge of regulatory requirements related to patient accounting, including a solid understanding of Medicare, Medicaid and managed care processes.
• Ability to work and communicate effectively with a diverse group of people including other department managers, staff, physicians, patients, and the public.
• Ability to read, analyze and interpret financial reports, contracts, and other legal documents.
• Outstanding ability to work independently to achieve results. Often, there is no precedent for and little help in carrying out assigned tasks. Must originate, plan, adapt and invent to accomplish tasks.
• Ability to set and maintain priorities when dealing with multiple demands and interruptions.
• Strong analytical and problem-solving skills.
• Dedication to the development of others and willingness to coach and mentor people as necessary to promote their personal and professional growth.
• Intermediate computer skills including email, word processing, spreadsheets, and working with graphics.

OTHER SKILLS AND ABILITIES

• Ability to interact with patients, families, visitors and co-workers.
• Ability to interact assertively and tactfully when dealing with conflict and in group solving activities.
• Ability to demonstrate a professional, open-minded approach in identifying problems and resolving problems/conflicts.

Please send your resume or questions in confidence to:
Amy Lowe
Senior Recruiting Director
Impekkable
Amy.Lowe@impekkable.net
Mobile – (972) 921.1864 (call or text)

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