Director of Revenue Cycle Management
Director of Revenue Cycle Management
We are looking for passionate, motivated people who want to join a fast-growing company that delivers state of the art medicine/technology to cancer patients. This is an incredible opportunity located at our Chicago based treatment center (approx 30 min west of downtown Chicago).
GENERAL DESCRIPTION
This position will work closely with the treatment centers’ Director, Clinical Services to provide training and oversight of the centers business office functions including patient registration, financial intake, coding, billing, posting, cash collections and reporting. The incumbent will coordinate communication and activities which relate to the business office functions between the treatments centers and parent company including payer relations/contracting, patient care, accounting and outsourced contractors who provide billing and collection services for the company. Qualified candidates will have an extensive knowledge of healthcare insurance, healthcare financial services, healthcare coding & billing, cash posting, collections and customer service.
RESPONSIBILITIES
• Provides functional leadership to financial intake staff which includes: assistance with financial on boarding of patients requiring coordination with medical patient intake (as needed), contracting/payer relations, contracted service providers, physicians and insurance carriers. Provides technical training and ensures that programs, operating policies and procedures are being followed and that center financial objectives are considered.
• Provides functional leadership for all billing functions which includes: leading evaluations of RCB and developing optimal cross communications at field, corporate and RCB; assistance with code capture and review, which may require coordination with clinical staff, financial intake and contracted service providers; representing field in routine meetings with billing vendor to surface issues and lead resolution; provides technical training and ensures all operating policies and procedures are being followed and that center financial objectives are considered; understands and documents CPT purpose/usage by procedure; monitor CPT changes
• Work with outside billing vendor to check claims for coding errors and anomalies.
• Understand and help monitor outside billing vendor’s internal and external edits for clean claims processing.
• Lead the evaluation and potential development of CBO including a timeline and action plan of in-housing outsourced billing component.
• Provides assistance to reimbursement team in responding to requests for information from payers and effectively assist team in working through an appeals process.
• Manages external contractors who provide billing and collections services for the centers to ensure that quality standards, operating policies and procedures and financial objectives, as defined by the center and parent, are being met/exceeded.
• Document, monitor and modify as necessary each critical step in Revenue Cycle Management from Chart Documentation to Cash Posting (including all functional areas); works with QA team to develop QA measures around the same.
• Reviews results of ongoing, recordable billing audits to ensure billing compliance, maximized revenue capture; and develop/implement corrective procedures as needed.
• Coordinates with business office staff and IT in building/maintaining Mosaiq and other data bases/files for the centers electronic medical records.
• Collaborates with medical and clinical staff leadership and/or President in analyzing and planning technical training and programs to meet internal client needs related to business office functions.
• Coordinates and/or presents training classes/programs for billing/financial counseling staff.
• Assesses impact of and feedback from training in developing strategies for quality improvement related to the revenue cycle and communicate those proposals and changes to internal stakeholders: Center Presidents, Accounting and Reimbursement.
• Works with treatment center analysts and Director of accounting to interpret, analyze and present revenue reports.
• Lead analysis and support of A/R aging.
• Analyze adequacy of bad debt and contractual allowances as well as adequacy of contractual allowances through hindsight testing.
• Reconcile billing and collections with the managed care contracts to ensure we receive proper payment for all payers.
• Ensure MDs and facility receives maximum reimbursement/payment for service.
• Provides exemplary leadership to all business office employees.
• Maintains current knowledge of all billing and insurance requirements for Medicare and Medicaid (as applicable by state) as well as commercial payers.
• Offers and implements continuous improvement ideas for billing and insurance areas to enhance revenue.
• Responsible for contributing to performance evaluations of billing, insurance and financial counseling personnel.
WORK EXPERIENCE REQUIREMENTS
• Minimum of 10 years experience in managing/supervision a Central Business Office (including billing, collection, financial intake and managed care) for a heath care facility, with a track record of growth and profitability.
• Radiation Oncology experience a plus
REQUIRED SKILLS AND ABILITIES
• Basic supervisory principles and practices.
• Healthcare billing and insurance expertise.
• Exemplary customer satisfaction skills, including dealing effectively with the public, both in person and over the telephone.
• Proficient using all Microsoft Office products.
• Experience using Mosaiq/IMPAC software preferred
• Experience using healthcare billing software programs
• Commanding knowledge of Medicare and 3rd party reimbursement principles
COMPETENCIES
• Problem Solving/Analytical Skills
• Organization, Attention to Detail & Time Usage
• Performance Standards/Results Orientation
• Competency/Dependability/Thoroughness
• Fostering Teamwork
EDUCATION/DEGREE
• Bachelor’s degree in Business or related field. Additional experience may be accepted in lieu of degree.
• Certified Medical Coder preferred.
OTHER
• While this job description outlines the general duties and responsibilities of this role, the incumbent may be asked to perform other functions and duties as required or assigned.
