Director of Revenue

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    "requisitionDescription": "<div><div><div><p id=\"isPasted\"><strong>ESSENTIAL DUTIES/RESPONSIBILITIES:</strong></p><ul><li>Oversee and support the daily operations of all patient financial services (PFS) functions, including billing, follow-up and collections, cash posting and all Patient Access areas.</li><li>Work closely with other departments (HIM, Case Management, Information Technology, Clinics, etc.) to streamline procedures that will help ensure correct billing to patients and payers in a timely manner, thereby expediting Clinic receivables.</li><li>Oversee the work schedule and direct changes in priorities and schedules as needed to ensure work is completed in an efficient and timely manner and to improve the department&rsquo;s performance and service.</li><li>Implement a Quality Assurance program for PFS functions and monitor staff and team performance, making changes, when required, to support accurate billing to payers and patients in a timely manner and compliance with laws and department procedures.</li><li>Assist with the development of budgets and monitoring of department operations to achieve goals within the budget.</li><li>Ensure compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers.</li><li>Maintain appropriate internal controls for the safeguarding of cash.</li><li>Follow and monitor compliance with Clinic policies and standards.</li><li>Develop, redesign, and monitor key performance indicators including payer mix, A/R, collection rates, adjustments, bad debt write off, estimated collections, appeal success rates, and other requested parameters.</li><li>Maintains extensive knowledge of revenue cycle and regulatory requirements associated with governmental, managed care, and commercial payers.</li><li>Serves as the subject-matter expert on regulatory, compliance, and legal requirements associated with medical billing and CMS. Ensures compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers.</li><li>Develops and maintains internal controls to target revenue recovery throughout the organization by identifying charge capture, coding, and reimbursement problems, then recommending/implementing solutions.</li><li>Monitor A/R effectively and ensure aging categories are within established goals and national benchmarks.</li><li>Responsible for maximizing the collection of medical services payments and reimbursements from patients, insurance carriers, financial aid, and guarantors.</li><li>In conjunction with operations, reviews and enhances insurance verification, coding review, billing, collection, and payment posting processes for efficiency and best practices; ensure systems are fully functional and maximized and recommend new processes to improve current workflow.</li><li>Monitors daily productions of claims, denials, and appeals.</li><li>Analyzes claims, utilization, and medical cost data.</li><li>Monitors aged accounts and verify appropriate collections procedures are being followed.</li><li>Reviews, monitors and recommends updates to the Clinic&rsquo;s fee schedule to maintain fees at levels that maximize reimbursement.</li><li>Ensures compliance with relevant federal, state, and payor-specific billing requirements.</li><li>Regularly provides upper management with revenue cycle status including reports, metrics, and presentation.</li><li>Establish a regularly scheduled revenue cycle meeting to discuss strategies and ensure everyone is educated on the direction of the department.</li><li>Work with Managed Care vendors in identifying any payer relation issues or contracts that need to be renegotiated or negotiated for the first time.</li><li>Any and all other projects, goals, issues surrounding the revenue cycle, conflicts or concerns as directed or indicated by Administration.</li></ul><p>&nbsp;</p><p><strong>SUPERVISORY RESPONSIBILITIES:</strong><strong>&nbsp;</strong>Central Business Office ASC and Orthopedic Practice</p><p><strong>QUALIFICATIONS:</strong><strong>&nbsp;</strong>To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. &nbsp;The requirements listed below are representative of the knowledge, skill, and/or ability required. &nbsp;Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.</p><p><strong>Education:&nbsp;</strong>Bachelor&rsquo;s degree in healthcare administration, business, accounting, finance or related field with 5-7 years of management level experience in medical revenue cycle with expertise in billing and collections.<strong>&nbsp;</strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;</p><p><strong>Experience:</strong>Thorough knowledge of patient financial services processes and standards related to billing collections, and cash posting. &nbsp;General knowledge of patient registration, finance, and data processing. &nbsp; Knowledge of regulatory requirements related to patient accounting including a solid understanding of Medicare, Medicaid and managed care processes.</p><p><strong>Skills:</strong>Presentation skills, training management, motivating others, foster teamwork, coaching, and motivation. In addition, experience in Microsoft Suite (Word, Excel, and PowerPoint). &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;</p><p><strong>Other Skills: &nbsp;&nbsp;</strong>Strong analytical and problem-solving skills. &nbsp;&nbsp;</p></div></div></div>\n",
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