Revenue Cycle Director

Job Summary

Directs and oversees the overall policies, objectives, and initiatives of the organization’s revenue cycle activities to optimize the patient financial interaction. Performs a variety of financial duties in accordance with generally accepted accounting practices.

Essential Functions

• Review, design, and implement processes surrounding admissions, pricing, billing, third party payer relationships, compliance, collections and other financial analyses to ensure hospital and nursing home revenue cycle is effective and properly utilized.

• Track and report numerous metrics related to the patient engagement cycle including recording coding error rates and billing turnaround times to develop sound revenue cycle analysis and reporting.

• Manage relations with payers and providers to generate high reimbursement rates and a low level of denials.

• Manage the revenue cycle for hospital and nursing home while maintaining an orderly office with a smooth working atmosphere.

• Oversee all patient and resident billing and payment processes.

• Work directly with the Finance Office on all Revenue Cycle reporting and reconciling.

• Prepare and supply financial information for the auditors for the fiscal year end.

• Assist in preparing, validating and submitting Revenue Cycle information for the Medicare Cost Reports to the auditors.

• Manage staff schedule and coordinate all time off requests.

• Oversee HIM department.

• Work closely with department directors and administration to coordinate patient billing and payment requirements.

• Communicate with, guide and educate patients in regards to billing questions and concerns.

• Review and/or approve all Sliding Fee Applications.

• Oversee all patient or resident related A/R payments posted and deposited.

• Balance and reconcile bank deposits for Accounts Receivable.

• Assist in billing and follow up on patient accounts as needed.

• Provide back up for all Revenue Cycle duties: admitting, billing, payment processing, follow-up, Bad Debt, etc.

• Forward, track and communicate all Revenue Cycle Miscellaneous Cash to Finance Office.

• Keep Provider Enrollment current for all necessary payers, provide updates as needed, and enroll each new Provider and long-term Locum.

• Prepare outgoing mail as needed.

• Assist in the recruitment, interviewing, selection, training, evaluating, discipline and discharge of Business Office personnel. Ensure competency of all staff within department.

• Maintain Resident, Patient, Facility and Employee Confidentiality.

• Prepare for and attend all required meetings.

• Know and comply with Residents’ Rights rules.

• Treat Residents, Patients, Visitors and Co-workers with kindness, dignity and respect at all times.

• Attend and participate in orientation, training, mandatory education, in-services, staff meetings and education courses to further improve knowledge and skills, including Incident Command System training (ICS) for emergency preparedness.

• Promote teamwork; encourage others to work to the best of their ability.

• Have a positive attitude; be willing to accept change; follow facility rules, regulations and job assignments; accept suggestions well for work improvement; cooperate with other managers and administration and show respect at all times; speak well of company and job.

• Follow company dress code.

Education, Training and Experience

· Bachelor’s Degree in Business, Healthcare Administration or equivalent degree.

· Minimum of five years in a supervisory role.

· Good knowledge of common medical revenue cycle.

· Knowledge of Cerner is preferred.

· Knowledge of professional fee billing, reimbursement and third-party payer regulation and medical terminology.

· Working knowledge of regulatory requirements pertaining to health care operations and their impact on operations.

· Must be able to read, write, speak and understand English.

Worker Traits

· Basic computer skills.

· Strong problem-solving skills and ability to make timely decisions.

· Strong attention to detail.

· Demonstrated coding and billing knowledge/experience preferred.

· Experience with the physician credentialing process is preferred.

Physical Requirements

· Walking, reaching, grasping, bending, sitting, fine hand coordination, lift and carry up to 10 lbs.

· Vision including close, distance, color and adjust focus.

· Ability to hear.

· Ability to remain calm under stress.