Orthopedic Specialists of SW Florida
Director of Revenue Cycle
Orthopedic Specialists of SW Florida, 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 subspecialties. 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 activities.
Initial priorities will include developing the strategic vision, selecting third-party billing partners and executing billing initiatives.
Future priorities will include fine-tuning the operating activities to optimize revenue collections as well as develop key service and support metrics.
In this role, the Director, Revenue Cycle Operations will work closely with executives, directors, physicians, and managers as well as third parties.
Hands-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 support.
Prepares daily, weekly and monthly RCM reporting metrics to remediate any items outside established KPI including status report of projects.
Effectively implement denial management reduction through process improvements, coordinating direct or indirectly, with internal team and offices to improve workflows and provide training and education.
Maintain understanding and communicates payor policy changes across the market.
Responsible for Worker’s compensation relations and statutory changes.
Promote positive attorney relations, stay current with PIP laws, and negotiate personal injury case settlements.
Meet with payor representatives for timely remediation of large denial or underpayment projects.
Formulate and execute policies and procedures to ensure the billing workflow is highly effective.
Daily reviews of the following programs: Incoming claim/denial volumes, daily billing, rejections, evaluate clean claim rates, and team workflow.
Presents first-line negotiation of payer contracts on an annual basis to the CEO and CFO.
Evaluate and communicate fee schedule changes, or changes that affect payments annually.
Annual charge master analysis and implementation.
Develops quality control program to meet the company's quality initiatives.
Ensure productivity goals are monitored and quickly re-mediates barriers to achieving those goals at the individual and/or team level.
Counsels and disciplines employees in accordance with department goals and policies.
Maintain compliance with directives from all regulatory agencies and third parties.
New provider onboarding, train on billing processes, also working in coordination with credentialing supervisor.
Ensure staff compliance with coding, PCI, insurance company policy changes.
Collaborate with other departments to maximize training and efficiency.
Maintain department compliance with state and federal regulations.
Required to attend all executive meetings.
Attend conferences pertaining to orthopedics or billing at the discretion of the CFO.
Minimum Requirements:
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 preferred.
Experience with a large group, growing healthcare organization support.
Extensive knowledge of patient registration, coding, billing, regulatory requirements, billing compliance, business operations, financial systems and financial reporting.
Strong work ethic, attention to detail, knowledge of the claims process, coding, billing, collections and credentialing.
Benefits:
Competitive Pay
Generous PTO Allowance
6 Paid Holidays
401K
Affordable Medical, Dental, & Vision Insurance and more!
Additional Comments:
Drug Screening is required.
Orthopedic Specialist of SW FL. participates in E-Verify.
Criminal 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
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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 subspecialties. 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 activities.
Initial priorities will include developing the strategic vision, selecting third-party billing partners and executing billing initiatives.
Future priorities will include fine-tuning the operating activities to optimize revenue collections as well as develop key service and support metrics.
In this role, the Director, Revenue Cycle Operations will work closely with executives, directors, physicians, and managers as well as third parties.
Hands-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 support.
Prepares daily, weekly and monthly RCM reporting metrics to remediate any items outside established KPI including status report of projects.
Effectively implement denial management reduction through process improvements, coordinating direct or indirectly, with internal team and offices to improve workflows and provide training and education.
Maintain understanding and communicates payor policy changes across the market.
Responsible for Worker’s compensation relations and statutory changes.
Promote positive attorney relations, stay current with PIP laws, and negotiate personal injury case settlements.
Meet with payor representatives for timely remediation of large denial or underpayment projects.
Formulate and execute policies and procedures to ensure the billing workflow is highly effective.
Daily reviews of the following programs: Incoming claim/denial volumes, daily billing, rejections, evaluate clean claim rates, and team workflow.
Presents first-line negotiation of payer contracts on an annual basis to the CEO and CFO.
Evaluate and communicate fee schedule changes, or changes that affect payments annually.
Annual charge master analysis and implementation.
Develops quality control program to meet the company's quality initiatives.
Ensure productivity goals are monitored and quickly re-mediates barriers to achieving those goals at the individual and/or team level.
Counsels and disciplines employees in accordance with department goals and policies.
Maintain compliance with directives from all regulatory agencies and third parties.
New provider onboarding, train on billing processes, also working in coordination with credentialing supervisor.
Ensure staff compliance with coding, PCI, insurance company policy changes.
Collaborate with other departments to maximize training and efficiency.
Maintain department compliance with state and federal regulations.
Required to attend all executive meetings.
Attend conferences pertaining to orthopedics or billing at the discretion of the CFO.
Minimum Requirements:
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 preferred.
Experience with a large group, growing healthcare organization support.
Extensive knowledge of patient registration, coding, billing, regulatory requirements, billing compliance, business operations, financial systems and financial reporting.
Strong work ethic, attention to detail, knowledge of the claims process, coding, billing, collections and credentialing.
Benefits:
Competitive Pay
Generous PTO Allowance
6 Paid Holidays
401K
Affordable Medical, Dental, & Vision Insurance and more!
Additional Comments:
Drug Screening is required.
Orthopedic Specialist of SW FL. participates in E-Verify.
Criminal 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
#J-18808-Ljbffr