Revenue Cycle Director

Description

Job Summary

Directs and oversees the overall policies, objectives, and initiatives of the organization's revenue cycle activities to optimize the patient financial interaction. Performs a variety of financial duties in accordance with generally accepted accounting practices.

Essential Functions

1. Review, design, and implement processes surrounding admissions, pricing, billing, third party payer relationships, compliance, collections and other financial analyses to ensure hospital and nursing home revenue cycle is effective and properly utilized.

2. Track and report numerous metrics related to the patient engagement cycle including recording coding error rates and billing turnaround times to develop sound revenue cycle analysis and reporting.

3. Manage relations with payers and providers to generate high reimbursement rates and a low level of denials.

4. Manage the revenue cycle for hospital and nursing home while maintaining an orderly office with a smooth working atmosphere.

5. Oversee all patient and resident billing and payment processes.

6. Work directly with the Finance Office on all Revenue Cycle reporting and reconciling.

7. Prepare and supply financial information for the auditors for the fiscal year end.

8. Assist in preparing, validating and submitting Revenue Cycle information for the Medicare Cost Reports to the auditors.

9. Manage staff schedule and coordinate all time off requests.

10. Oversee HIM department.

11. Work closely with department directors and administration to coordinate patient billing and payment requirements.

12. Communicate with, guide and educate patients in regards to billing questions and concerns.

13. Review and/or approve all Sliding Fee Applications.

14. Oversee all patient or resident related A/R payments posted and deposited.

15. Balance and reconcile bank deposits for Accounts Receivable.

16. Assist in billing and follow up on patient accounts as needed.

17. Provide back up for all Revenue Cycle duties: admitting, billing, payment processing, follow-up, Bad Debt, etc.

18. Forward, track and communicate all Revenue Cycle Miscellaneous Cash to Finance Office.

19. Keep Provider Enrollment current for all necessary payers, provide updates as needed, and enroll each new Provider and long-term Locum.

20. Prepare outgoing mail as needed.

21. Assist in the recruitment, interviewing, selection, training, evaluating, discipline and discharge of Business Office personnel. Ensure competency of all staff within department.

22. Maintain Resident, Patient, Facility and Employee Confidentiality.

23. Prepare for and attend all required meetings.

24. Know and comply with Residents' Rights rules.

25. Treat Residents, Patients, Visitors and Co-workers with kindness, dignity and respect at all times.

26. Attend and participate in orientation, training, mandatory education, in-services, staff meetings and education courses to further improve knowledge and skills, including Incident Command System training (ICS) for emergency preparedness.

27. Promote teamwork; encourage others to work to the best of their ability.

28. Have a positive attitude; be willing to accept change; follow facility rules, regulations and job assignments; accept suggestions well for work improvement; cooperate with other managers and administration and show respect at all times; speak well of company and job.

29. Follow company dress code.

Requirements

Education, Training and Experience

• Bachelor's Degree in Business, Healthcare Administration or equivalent degree.

• Minimum of five years in a supervisory role.

• Good knowledge of common medical revenue cycle.

• Knowledge of Cerner is preferred.

• Knowledge of professional fee billing, reimbursement and third-party payer regulation and medical terminology.

• Working knowledge of regulatory requirements pertaining to health care operations and their impact on operations.

• Must be able to read, write, speak and understand English.

Worker Traits

• Basic computer skills.

• Strong problem-solving skills and ability to make timely decisions.

• Strong attention to detail.

• Demonstrated coding and billing knowledge/experience preferred.

• Experience with the physician credentialing process is preferred.

Physical Requirements

• Walking, reaching, grasping, bending, sitting, fine hand coordination, lift and carry up to 10 lbs.

• Vision including close, distance, color and adjust focus.

• Ability to hear.

• Ability to remain calm under stress.