Director of Revenue Cycle

Location: Norton, Kansas
Date Posted: 10-02-2018
Company: Norton County Hospital
Job Title: Director of Revenue Cycle
Job Classification:   Exempt, Full-Time   
Reporting Relationship: Chief Financial Officer (“CFO”)
 
Primary Accountability: 
The Director of Revenue Cycle is responsible for directing, planning and organizing the staff and accounts receivable activities of Norton County Hospital (“NCH”)’s departments administering inpatient, outpatient, physicians’ billing, cashiering, credit and collection, cash application, private ambulatory, emergency and clinic registration services. The Director of Revenue Cycle is responsible for collaborating with other Hospital departments to ensure optimal system registration flows as well as ensure the integrity of data collected.
 
Major Responsibilities and Duties:
  • Manages the day-to-day billing operations within the hospital and clinic with special emphasis on the front-end systems to assure that all information provided to billing is accurate and timely across all divisions and locations to include: registration; scheduling; referral management; co-pay collection; self-pay collection; systems set up and issues.
  • Works collaboratively with the IT team to ensure systems integrity for the revenue cycle functions.
  • Oversees denial work file management to include denial code work file management by coders to ensure timely submission of charges to billing and completes appropriate paperwork to show that all services are captured.
  • Collaborates with Managers and staff to ensure claims processing occurs in a timely manner.
  • Coordinates edit code training for front-end staff.
  • Manages the entire pipeline of charge capture activities from encounter form development and review to correct coding and oversight for ensuring accurate reimbursement for services billed.
  • Drives process improvement initiatives related to front-end revenue cycle functions, in collaboration with the operations leadership.
  • Analyzes month end reports, identifies opportunities for work process improvements with respect to claims denials and works with Managers on strategies to improve front-end related issues.
  • Oversees and provides input to ensure all systems are functional in categories such as dictionary file, data elements, interface and mapping, payer specificity, file transmission, billing area set, etc.
  • Coordinates and facilitates compliance audits for the facility; directs internal compliance reviews conducted by the department coders; provides feedback and education to physicians on coding errors for both procedure and other services; verifies that fee schedules are appropriate against insurance payers' allowable fees.
  • Serves as a key resource for changes in payment and coding guidelines from all payers; continuously educates, reeducates and updates physicians on coding changes and other relevant updates.
  • Facilitates and influences the credentialing process to assure prompt ability to bill for services rendered by newly hired physicians.
  • Analyzes monthly Appeals reports, tracking work effort by billing to ensure collections activity on a regular basis; analyzes weekly charges and payments data to ensure billing is on track to meet established targets for productivity.
  • Reviews EOBs as needed to determine/address payer problems; coordinates efforts regarding authorization issues.
  • Directs, manages and supports employees daily work activities and development; undertakes the following employment actions: hiring, termination, training, corrective action and performance reviews.
  • Plans, monitors and manages the department budget; manages the efficient use of the department budget.
  • Assesses and makes recommendations to improve the efficiency of current systems/processes for applicable registration and financial services.
  • Formulates and implements policies and procedures to facilitate and optimize the efficient functioning and operations of related departments; develops and maintains current departmental manuals, where applicable.
  • Develops financial programs consistent with changing regulatory and fiscal environment in accordance with NCH’s mission and vision.
  • Develops and monitors strategic operating goals, objectives and budget; and reports operational performance, justification and/or corrective action.
  • Communicates patient-related information to appropriate departments, as necessary.
  • Ensures compliance with applicable laws and regulatory standards.
 
Qualifications:
  • Bachelor’s Degree in Business Administration, Public Administration, Finance or related field; required. Master’s Degree in Hospital or Business Administration, Finance or related field preferred.
  • Minimum of three (3) years of direct management experience (Departmental Director or above) in a health system or hospital revenue cycle department required.
  • Minimum of seven (7) years revenue cycle experience required.
  • Knowledge of medical terminology and current healthcare trends/policies.
  • Proficient with MS Office including Excel, Outlook and Word as well as other relevant financial applications which evolve over time.
  • Skilled in establishing and maintaining effective interpersonal relationships with all levels of management, physicians, employees, business, government and community officials and the general public.
  • Skilled in problem solving, negotiations, and issue identification in employee situations.
  • Strong analytical and resource management skills requiring quick, effective decision making under pressure.
  • Ability to direct and manage within a large organization and ability to integrate and harmonize diversified managerial functions involved in the operations, support and administration of a large health care organization.
  • Ability to organize, plan, execute, control and evaluate activities within the Hospital’s revenue cycle.
  • Ability to operate in a fast-paced environment.
  • Strong team building skills and the ability to effectively gain consensus among multiple constituencies.
  • Ability to prioritize and manage work effectively and efficiently with high energy, to accomplish tasks while managing multiple projects at the same time and delivering friendly service.
  • Must have the ability to respect diversity and individual needs.
 
Physical Demands:
  • Ability to be in a stationary position for 85% of an eight (8) hour work day.
  • Ability to occasionally move about inside the office to access file cabinets, office machinery, etc.
  • Read computer screens and mail, email, talk on the phone.
  • Ability to hear clearly.
  • Ability to lift up to 25 pounds unassisted or with minimal assistance.
 
Work Environment:
  • Professional hospital setting.
  • Conditions such as noise and odors may cause some discomfort.
  • Exposure to potentially dangerous materials and situations which require following extensive safety precautions and may include the use of protective equipment. 
  • Interaction with staff and patients.
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