Revenue Cycle Director

Description

Position Title: Director of Revenue Cycle

Department: Finance 

Supervisor Title: Chief Financial Officer

Summary

While upholding the Star Valley Health mission, vision and values this key position is responsible for the oversight of all aspects of the revenue cycle process including (1) in-house areas of admissions, cashiering and Health Information Management; and (2) fully out-sourced functions of coding, transcription, billing, collections, and auditing. (NOTE: Outsourcing partner is Optum.) In addition, the position works with revenue-generating departments to enhance the efficiency (i.e., revenue to cash velocity) of the revenue cycle process, the charge master, denials management, and reimbursement issues, etc. Ultimately, the position ensures the patient experience is enhanced by the interaction with billing for hospital services – ensuring no surprises as patients are enabled to deal with their health care obligations related to care received and Star Valley Health. This is an “at will” position.  

*Please note, candidates must have experience with EPIC EMR and critical access hospital revenue cycle operations.

Job Duties

• Maintains a clear understanding and fully adheres to the corporate compliance program/policies.
• Development and implementation of revenue cycle policies and procedures to ensure efficient, effective processes for revenue cycle management.
• Manages relationship with Optum – our primary outsourcing partner in the Revenue Cycle – to achieve Best Practice results.
• Plans and directs patient insurance, billing, collections, and HIM processes.
• Successfully resolves payer payment delays, credit balance resolution, exceptions, probable bad debt, and any identified trends resulted in delayed payments.
• Creates and maintains a system of internal controls for the entire revenue cycle.
• Demonstrates exceptional customer service and interacts effectively with physicians, patients, staff and visitors.
• Conduct regular audits of department productivity and implement changes as appropriate to maximize efficiency.
• Work with leadership through the charging process, to enhance reimbursement and decrease denials.
• Review charges for accuracy and completeness of procedural and diagnostic codes.
• Maintains accuracy and compliance of charge capture tools.
• Maintain a working knowledge of the federal, state and private insurance requirements and regulations.
• Prepares and maintains operating plans, revenue and cash forecasts, quality assurance and other reports for departments or functions.
• Must be willing to visit off-site facilities as needed.
• Direct and participate in committees dealing with the revenue cycle process.
• Ensures that information systems support current and future needs of the department. Works closely with information technology to maintain high quality data integrity. Works with risk management, legal counsel, and administrative staff to ensure that the organization has and maintains appropriate compliance including privacy, security, and confidentiality policies, procedures, forms, information notices, and materials which reflect current organizational practices and regulatory requirements.
• Perform other duties as needs arise or assigned.

Requirements

Requirements

Abilities & Skills:

• Knowledge of principles and systems associated with revenue cycle management and medical coding (CPT and ICD-10)
• Knowledge of medical collections related to group insurance, Medicare and Medicaid, workers’ compensation and self-pay accounts
• Professional verbal and written communication including the ability to participate in and facilitate group meetings 
• Sound analytical and problem-solving skills
• Proficient with Microsoft office products
• Multi-tasking skills with the ease of changing directions upon request and need
• Strong leadership, decision making skills and comfort in dealing with executive leadership
• Physical requirements include but are not limited to constant sitting, standing, walking, pushing, pulling, typing, utilization of computer, occasional lifting or twenty-five (25) pounds unassisted

Experience & Education:

• Experience with EPIC is required
• Minimum of 5 years of in-depth experience in managing hospital revenue cycle operations, with preference for specific experience with Critical Access Hospitals
• Minimum of 5 years of leadership/management experience
• Business or related degree preferred

Note: Position descriptions are intended to serve as a guideline for typical duties and requirements of a position, but are not inclusive. Additional or different responsibilities within a reasonable scope of the position description may be added or deleted any anytime at the discretion of the Board.

Salary : $117,000 - $165,000