DIRECTOR OF REVENUE CYCLE - POST BILL
Full Time
Indianapolis, IN 46227
Posted
Job description
Company: Priority Ambulance, LLC
Reports To: Chief Revenue Officer
Summary:
The Director of Revenue Cycle – Post-Bill reports directly to the Chief Revenue Officer (CRO). As the Director of Revenue Cycle, you will lead the overall strategy and optimization of revenue cycle operations, systems, policies and procedures to apply improvement to insurance follow up processes, monitor trends that are causing a delay in claim resolution, identify coding issues, ensure all claims were accepted by the payers, reporting of results and analysis. In additions, this position will oversee concurrent and retrospective auditing, proper coding, credentialing, insurance contract review, and customer service efforts related to revenue cycle activities. Staff development, culture creation and upskilling are key elements of success for this role.
Duties and responsibilities include but not limited to the following:
- Develops and implements RCM initiatives that achieve strategic goals consistent with the Chief Executive Officer, Chief Financial Officer's, and CRO’s priorities and vision.
- Identifies and measures key performance indicators (KPIs) to promote output, performance management, and organizational growth
- Benchmarks the ongoing accounts receivables KPIs, and works with staff to improve performance when key indicators show benchmarks are not being attained
- Creates and modifies policies and procedures to address customer needs, compliance, efficiency, and internal control requirements
- Evaluate performance of staff by establishing objectives and providing constructive feedback on a regular basis.
- Demonstrates effective problem-solving and action planning skills to improve internal and external operations.
- Skilled in leading change management to implement new and “best practice “approaches to business processes to improve customer service, operational effectiveness and financial outcomes.
A critical function of this position is to provide support to, and participation with the CRO and other C-level Leadership in facilitating the implementation of systems, processes, and procedures to ensure regulatory compliance, and maintaining an awareness of changes in healthcare matters that directly or indirectly impact the revenue of the company. This role manages team members and has operational oversite for assigned Billing Center(s). The position will communicate with insurance carriers and work collaboratively with department leaders and external business groups to identify systemic issues, develop solutions, and implement process changes. At all times, the position shall represent the organization in a professional manner while effectively driving collections to meet business objectives.
Other specific duties include:
- Prepare and submit reports on a timely basis as required and directed by the CRO. This will include presentation to operational Group Presidents and C-Level Management.
- Monitor and manage the accounts receivable collection process
- Contribute financial expertise in the planning of new services, markets and acquisitions.
- Heavily participate in and assist the CRO in acquisition due diligence and integration.
- Attend Executive meetings, seminars, and workshops, to assure current knowledge of State and Federal laws and regulations, reimbursement trends, and patient satisfaction pertaining to Revenue Cycle functions.
- Ensure regulatory filings (IE: revalidations, enrollments, updates to enrollments) for assigned billing centers and markets are current, complete and accurate.
- Develop best practices for process improvement for overall Revenue Cycle Management.
- Maintains continual knowledge of payor policies to assure optimal reimbursement for all services performed within the system, in compliance with government and third-party payor regulations.
- Plan, promote and conduct system-wide performance improvement activities specifically looking for ways to improve efficiency and effectiveness within assigned centers and markets.
- Coordinate and conduct regular team meetings between assigned operations and billing teams.
- Budgetary oversight of assigned departments, facilities and organizational structure across multiple sites.
- Monitor and make recommendations to ensure effectiveness of DQA processes with Operations ensuring an effective revenue cycle, including insurance verification, high volume medical transport QA and quality control.
- Monitor and make recommendations to ensure an effective Patient Care Record (PCR) program / process that includes electronic storage of all PCRs, effective workflows, documentation training, document retention, and documentation enhancements (such as close call rules).
- Manage large-scale projects driving process change improvements and policies throughout the company.
- Oversight of daily, weekly, monthly, quarterly and yearly reports comprised of key performance indicators (KPIs); monitor and analyze charges, payments, adjustments, AR and other data elements.
- Other duties as assigned.
Qualifications and Skills
- Individual with the talent to meet a continually changing set of circumstances.
- Extensive knowledge and understanding the ambulance industry including regulations relating to Medicare, Medicaid and commercial insurance providers a plus
- Proven revenue reporting and analytical skills.
- Excellent verbal and written communication skills.
- Very strong strategic, vision and process change improvement leader.
- Advanced proficiency in accounts receivable management.
- Strong analytical, problem solving, root cause analysis skills to evaluate problems and interpret trends.
- Experience in business office and call center management, medical billing, accounts receivable collections and healthcare or EMS background required including Medicare and Medicaid billing requirements.
- Demonstrated process improvement, project management, workflow, benchmarking and evaluation of business processes required.
- History of proven ability to leverage technology to advance workflow efficiency
- Proven ability to effectively lead teams and individuals.
Education
Degree in Accounting, Finance or Business (or equivalent work experience)
Experience
- Revenue Cycle Operations Leadership role(s): 5 years (Required)
- Leadership of team of over 30 people: 5 years (Required)
- Experience leading RCM Functions of companies greater than $100M (Required)
- Multi-State/Multi-Unit/Remote-Management Experience (Required)
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