Executive Director, Revenue Cycle

Description

Job Summary

Responsible for the development and direction of revenue cycle management operations for Illinois Bone & Joint Institute. Develops strategies to optimize operations and revenue efficiency. Establishes targets, policies, and internal controls that will drive improvements and efficiencies in overall service revenue capture and collection. Ensures compliance with regulatory requirements and responsiveness to changes in requirements. Coordinates with stakeholders across the organization to drive optimal financial performance.

Duties and Responsibilities

• Reviews, designs, and implements processes to ensure the revenue cycle is effective and run efficiently
• Implements and monitors collection procedures, minimizing contractual and bad debt write offs, and maximizing cash collections
• Tracks numerous metrics related to the revenue cycle including coding error rates, denials, accounts receivable to develop sound revenue cycle analysis and reporting
• Monitors analytical data of revenue cycle to be proactive in operations
• Performs ongoing trend analysis of third party payer rejects and denials. Develops training programs for registration, billing, and coding staff to eliminate/reduce rejects/denials
• Monitors and ensures adherence to payer guidelines and regulatory compliance
• Manages payer and speciality contracts to ensure contract compliance
• Performs ongoing trend analysis on third party payer payments to ensure reimbursement is in accordance with allowable amounts stated in agreements and contracts. Works with appropriate individuals to resolve discrepancies
• Develops policies/procedures to support the functional infrastructure
• Champions revenue cycle improvements throughout the organization including working with appropriate individuals to aid the resolution of identified revenue cycle issues
• Provides direction and leadership within the reimbursement, coding & compliance departments of revenue cycle
• Provides financial support and analysis to physician practices through communication and education
• Meets with practices/individuals to review specific coding and collection issues
• Actively participates in staff development and assessments to support industry best practice

Requirements

Knowledge, Skills and Qualifications

• Bachelor degree in related field or equivalent experience.
• Certified coder preferred
• Minimum of ten (10) years of medical billing experience Minimum of five years in a supervisory role
• Knowledge of professional fee billing, reimbursement and third party payer regulations and medical terminology is required
• Knowledge of all regulatory reimbursement and insurance related requirements
• Strong working knowledge of medical terminology, CPT, HCPCS, ICD9 and ICD10
• A systematic approach to problem solving for all types of issues
• Strong skills in fostering working relationships
• Detail oriented; organized; sets priorities; meets deadlines
• Advanced skills in computer programs, particularly Microsoft Excel
• Effective and clear oral and written communication skills with individuals and groups

Supervisory Relationship

• Reports to Chief Operating Officer