Job opening for a Revenue Cycle Director located in North Central Washington.
Critical Access Hospital
Current Director is retiring
Director of Revenue Cycle is responsible for reviewing, designing and implementing processes surrounding admissions, pricing, claim submission and management, charge capture, denial management, third party payer relationships, compliance, collections and other financial analyses related to the overall revenue cycle process. Track metrics to develop sound revenue cycle analysis and reporting. Manage relations with payers and providers to generate high reimbursement and low denial rates.
- Implement and sustain best practices for all Revenue Cycle activities for Critical Access Hospital and Rural Health Clinic.
- 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.
- Implement training & education programs for onboarding and ongoing staff education as well as financial reporting dashboards in regards to the Revenue Cycle process to ensure the organization meets benchmarks.
- Oversee roles and responsibilities of direct reports, Billing and Patient Account Rep positions as well as all staff reporting up through these roles.
- Responsible for direct oversite for organization’s third party billing vendors, including but not limited to clearinghouse, payors, banking services, online payment services programs, credit card process companies and collection agencies.
- Work closely with IT Manager to maintain online payor portal and data requests.
- Work directly with host facility’s Cerner technical support for all issues related to Revenue Cycle.
- Monitor DNFB and ATB daily, working closely with HIM Manager and Business Office team to support timely billing and overall reduction in days in accounts receivable.
- Manages all complaints from patients that require a charge, billing or payment review through the facilities QMM platform while working parallel with the Director of Quality to ensure timely resolution.
- Responsible for monitoring new regulations involving the Revenue Cycle process, develop processes and/or policies to manage these regulations and maintain compliance.
- Directly responsible for and evaluate the effectiveness of outside agencies working within Revenue Cycle.
- Establish and maintain control for all cash collected and posted in the Patient Accounting System.
- Work with the Admitting Coordinator and oversee the process/procedure for registration of benefits, ensuring quality meets benchmark.
- Work with the Admitting Coordinator and oversee an established process for eligibility and benefit verifications and time of service collection requirements.
- Work with the Admitting Coordinator and oversee procedures are developed related to admitting areas, insurance processing, Medicare Secondary Payer (MSP) quality assurance and overall compliance.
- Effectively recruit, hire and orient new hires for Revenue Cycle reporting positions. Develops retention strategies. Assist employees in developing goals to improve job performance. Supervise and maintain productivity of all employees
- Provide training and feedback on competencies for performance reviews for all employees within the department. Assure all department evaluations are performed timely.
- Makes recommendation on participation with healthcare contracts. Monitors these contracts for accurate payments
- Identify, collect and report relevant statistical data to CFO and Executive Team.
- Assist CFO with annual CDM pricing strategies.
- Member of the RAC team. Must have general understanding of RAC program. The team establishes process and procedures to manage audits, and verify compliance. Work closely with Compliance Officer on Revenue Cycle related issues as requested. Participates in all third party audits, as applicable.
- Conducts internal audits. Review and evaluate results. Make recommendations based on these results to improve revenue, work flows and/or compliance regulations
- Participates in interdepartmental process improvement and process evaluation efforts.
- Implement and promote excellent customer service
- Works conjunctively with the HIM Manager and CFO to maintain the ChargeMaster updates and follow up on department questions.
- Cost report work paper oversight specific to the revenue cycle process (ex. bad debt/charity care Exhibits) and ensure responsible staff completes by established deadline.
- Participate in monthly provider clinic meetings with the HIM Manager. Provide feedback and training as requested by Chief Medical Officer, Medical Director or Director of Quality.
- Attends in-services as required, participate in manager and director meetings.
- Lead department team meetings on a routine basis.
- Positive and supportive leader to staff members.
- Interaction with other departments in solving problems and working as a team.
- Demonstrates a professional, positive and caring attitude.
- Reviews all safety policies.
- Performs other duties as assigned.
- Maintains patient confidentiality at all times
- Upholds regulatory requirements to ensure continual compliance with departmental, hospital, state and federal regulations and policies.
- Follows all policies and procedures to ensure a safe environment for patients, public and staff
- Completes annual education, training, in-service, and licensure/certification requirements; attends departmental and organizational staff meetings or reads meeting minutes.
- Reports to work on time and as scheduled; completes work within designated timeframes.
- Establishes and maintains effective verbal and written communication and good working relationships with all patients, staff and vendors
- Utilizes initiative; strives to maintain steady level of productivity; self-motivated; manages activity and time.
- Actively participates in departmental and facility performance improvement and continuous quality initiatives.
- Attends and participates in meetings and is responsible for information communicated at meetings and emails.
- Attends all mandatory in service on a timely basis as scheduled.
- Participates as an active team member at staff meetings.
- Reads communications and acts upon in a positive and informative manner.
- Responds to all training/recertification notices timely and completes required training and/or recertification prior to deadline or expiration.
- Exercise a commitment to practicing behaviors that are in agreement with the spirit of cooperation and reflect the values described in the Code of Mutual Respect and Professionalism.
- Assists in maintaining an atmosphere of cooperation and teamwork with other departments and community partners.
- Demonstrates a genuine willingness to prevent or resolve inter-personal conflicts.
- Demonstrates the ability to participate in and/or implement team decisions.
- Adheres to HIPAA and all applicable privacy laws at all times, only sharing information on a “need to know” basis.
- Follows Infection Control procedures at all times.
- Be familiar with the collective bargaining agreement (Union Contract) of the UFCW21 and the Hospital.
- Bachelor’s Degree preferred
- Four years of senior healthcare management experience
- Three years in hospital revenue cycle billing or coding
- One year in hospital Charge Master maintenance and support
- One year working in Cerner Community Works platform
- Prefer experience within a Public Hospital District operating as a Critical Access Hospital.
Competitive Salary Range!
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