Job Description

Position Purpose:

The Associate Director of Revenue Cycle Operations will be responsible for the designing, planning, implementation and oversight of the enterprise revenue cycle functions. The Revenue Cycle Director will ensure that the organization maximizes net patient revenues while maintaining strong regulatory and legal compliance and high levels of customer service.

The Associate Director of Revenue Cycle Operations will be responsible for the development, implementation, and quality assurance of all revenue cycle policies and procedures. The Associate Director of Revenue Cycle Operations will oversee and have full responsibility for all aspects of Patient Financial Services, Patient Access Services, Revenue Integrity, and the Charge Description Master (CDM)

The Associate Director of Revenue Cycle Operations will provide oversight for direct reports and their subordinate staff including but not limited to staffing, evaluation, training, and continued development. The Associate Director of Revenue Cycle Operations is responsible for maintaining appropriate staffing levels based on the organizations goals, objectives, and fiscal budget.  The Associate Director of Revenue Cycle Operations will ensure that the supply of resources meets work demand and all teams are trained and compliant with standards and best practices. Responsible for revenue cycle initiatives and standardization of new technology and operational functions.

The Associate Director of Revenue Cycle Operations provides effective leadership and direction to all direct reports while managing and fostering a dynamic and progressive work environment characterized by high integrity, productivity, quality and a commitment to excellence and respect.

The Director must have superb management and business process skills to direct the team with respect to patient accounts receivables, customer service and operations. The Director is accountable for service performance and customer satisfaction and must have a proven record of accomplishment of successful outcomes with responding to inquiries or complaints from healthcare providers, and/or patients.

This Director is also responsible for coordinating and working cross-functionally with personnel from the Business Support Services groups. Business Support Services include: accounting, supply chain, enterprise information systems, and business development.  The Director is a key member of the leadership team. 

POSITION REQUIREMENTS:

Total Education, Vocational Training and Experience: Bachelor’s Degree in Business or equivalent experience of 8 years in related field.  Preferred education; Master in Healthcare/Business Administration or equivalent Master’s level education. 

Minimum 8 years of increasingly responsible experience and technical expertise, including experience successfully managing various projects and support teams. Outstanding grasp of and processes improvement. Demonstrated aptitude for effective leadership of multidisciplinary teams and staff.

Skills / Requirements

POSITION REQUIREMENTS

Total Education, Vocational Training and Experience: Bachelor’s Degree in Business or equivalent experience of 8 years in related field.  Preferred education; Master in Healthcare/Business Administration or equivalent Master’s level education.

Minimum 8 years of increasingly responsible experience and technical expertise, including experience successfully managing various projects and support teams. Outstanding grasp of and processes improvement. Demonstrated aptitude for effective leadership of multidisciplinary teams and staff.

SKILLS AND ABILITIES

  1. Ability to direct and organize others to meet established goals.
  2. Flexibility, willingness to facilitate change and to take on other duties as assigned
  3. Ability to effective manage and lead multidisciplinary teams and staff
  4. Proven ability to mentor and coach staff
  5. Ability to identify and business process areas of improvement and complex business needs and develop and implement required business process changes
  6. Possess excellent judgment and decision making skills.
  7. Ability to model, calculate and analyze operational business data.
  8. Expert use of computer office automation software and applications.
  9. Expert knowledge in Microsoft Office suite of products.
  10. Excellent, effective, and articulate communication.
  11. Demonstrates team work and collaboration.
  12. Ability to multi-task due to deadlines outlined by leadership.
  13. Flexibility, willingness to facilitate change and to take on other duties as assigned
  14. Commitment to excellent customer service.
  15. Possesses expert knowledge in all aspects of a business office to include; Insurance verification and authorization, patient financial counseling, charge entry and insurance billing for both government and commercial payers, and collections for government and commercial payers and patients .
  16. Possess expert knowledge of health insurance policies and practices.
  17. Has the ability to communicate effectively with patients, physicians, families, co-workers, management and other Center employees.
  18. Possess strong initiative and can work in a highly autonomous environment within the scope of the job.
  19. Is courteous, understanding and sympathetic toward patients, physicians and others.

Primary Position Responsibilities

  1. Work collaboratively with the executive management team to Plan, develop, organize, implement, evaluate and direct the operations of the Revenue Cycle team and business office.
  2. Oversee and coordinate revenue enhancement initiatives and business operations across all aspects of the revenue cycle operations team.
  3. Drive team performance to high achievement and high quality outcomes
  4. Focus on the development, performance and growth of direct reports by leading and developing coaching plans for each direct report aligned with organizational goals.
  5. Supervise the performance and provide evaluation of the Revenue Cycle operations team and business office.
  6. Review and maintain familiarity with payer contracts pertaining to the Revenue Cycle Operations team.
  7. Follow and stay updated on all compliance issues pertaining to all government and commercial payers that will affect billing regulations.
  8. Obtain and maintain familiarity with facility department software as it relates to billing and collection to ensure continuity of billing and financial services.
  9. Review the business office’s financial objectives, policies, and procedures periodically, at least annually, and make recommendations to the executive leadership team.
  10. Maintain a working relationship with all department heads and facility leadership and assist them in developing and using financial data as appropriate.
  11. Interpret and present the business office’s accounting policies and procedures to staffer, leadership, patients, family members, visitors, government agencies, etc., as necessary.
  12. Serve as a contact person for patient billing and other insurance issues.
  13. Oversee all verifications, coding, billing, and collections activity.
  14. Oversee all billing activity to include claim submission to government and commercial payers and patient billing. Gain proficiency in billing, level of service, codes and documentation guidelines that apply.
  15. Oversee accounts receivables and ensure prompt and regular follow up for all government and commercial payer accounts as well as patient receivables.
  16. Report trends and solutions to account delinquency to the executive management team.
  17. Oversee the balancing of all month end activities to include billed revenues and accounts receivable.
  18. Work with the managed care team to communicate with fiscal intermediaries, commercials payers, and TPA’s on issues concerning rates, rate changes, settlement payments, recoupments, etc . .
  19. Prepare financial and revenue cycle operational statistic(s) reports as directed.
  20. Ensure that patients are provided any financial notices required by state and federal laws and regulations (e.g. Medicare/Medicaid/SSI notice).
  21. Ensure that all staff are properly training on how to explain all financial documents provided to patient and responsible parties, including but not limited to ABN’s, assignment of benefits, HIPAA, admission agreements, etc.
  22. Performs any and all other duties as assigned by management.