Director Revenue Cycle

1 week ago

Stamford, Connecticut, United States Stamford Health Full time
Job Description

Stamford Health, a well-established, award winning Healthcare System with multiple locations in CT has an opportunity for Director of Revenue Cycle.

As a new Certified Great Place to Work organization, Stamford Health understands what it takes to attract talent in order to improve our workforce and support our mission, to that end we offer:
  • Competitive salary
  • Comprehensive, low-cost health insurance plans available day one
  • Wellness programs
  • Paid Time Off accruals
  • Tax deferred annuity and (403b) pension plan
  • Tuition reimbursement
  • Free on-site parking
*We are committed to building an inclusive workplace that values diversity and inclusion and reflects the diversity of the community and patients we serve.

Responsibilities

A system-level position overseeing all back-end cycle functions of the Enterprise, the Director of Revenue Cycle, Back End leaders and processes for Billing, Payer Credentialing, AR/Follow Up, Denials Management, Underpayments, Cash Posting, Credits and Self Pay Collections/Customer Service for Stamford Health. The incumbent will be responsible for daily operations of all back-end revenue cycle activities while operating in compliance with federal and state regulations, hospital and medical group related policies. The leader is responsible for implementing revenue cycle initiatives while overseeing operations and financial performance of the team's activities. Provides guidance and support in building one back-end revenue cycle team covering Stamford Hospital and Stamford Health Medical Group.
  • Collaborates with internal partners such as Middle and Front End revenue cycle leaders and Enterprise stakeholders; including, but not limited to, Managed Care. Information Services, Compliance, Risk Management, Case Management; Patient Relations; and clinical and operations leadership for the Hospital and the Medical Group to advance the organization's mission and strategic plan.
  • Develops policies and procedures regarding all backend revenue cycle processes. Maintains appropriate internal controls and safeguards over allowances and write-offs; ensures compliance with department policies to guarantee proper review and approval of adjustments.
  • Ensures compliance with state and federal laws and standards related to privacy and security. Meets all required reporting requirements for state and federal laws such as Medicare 838 Quarterly Credit Reporting.
  • Oversees all functions of back-end revenue cycle, including vendor management, to ensure accurate billing, follow up, collections, cash posting, insurance/patient refunds and customer service for appropriate maximum reimbursement and optimal consumer experience.
  • Oversees the preparation and submission of monthly bad debt write-off; ensures all hospital and regulatory guidelines are met. Monitors and evaluates collection agency performance to maximize bad debt recoveries; makes recommendations for changes when needed to improve cash flow.
  • Oversees the integration of the organization Back End revenue cycle functions with Front End.
  • Leads and collaborates with relevant function area leaders on all federal, state, financial, and third-party payer audit requests (ex: RAC, MSPQ, Equiclaim, Kepro)
  • Works closely with organization's managed care leader to resolve revenue cycle teams' escalations and lead system-level JOC meetings with managed care stakeholders. Identifies denial patterns and escalates with third party representatives or managed care contract administrators; contributes to the reduction of denials and lost revenues.
  • Collaborates with Executive Director and senior leadership on system-level strategy as an active member of the implementation/execution team.
  • Monitors relevant internal and external key performance indicators, meets all documented service level agreements, holds team accountable for results and meeting performance targets.
  • Provides appropriate training opportunities, mentorship, and support for team members in alignment with the organization's focus on employee engagement and satisfaction.
Qualifications

EDUCATION: Bachelor's degree required. Master's degree in Business Administration, Healthcare Administration or relevant equivalent strongly preferred.

EXPERIENCE: Ten plus years of professional and management experience with at least 5 years of direct supervision in two or more areas of back-end revenue cycle functions (Billing, AR/Follow Up, Denials Management, Underpayment/Variances, Credits, Cash Posting, Self-Pay Collections, Customer Service) required. Previous director level experience required.
  • Experience managing performance and developing a solid leadership team with more than ten years of experience in leading large revenue cycle hospital teams.
  • Must have ability to handle multiple priorities and work independently.
  • Current knowledge of HIPAA, Joint Commission standards, state and federal laws, Consumer Financial Protection Bureau, Legal, Compliance, and Vendor management.
  • Demonstrates knowledge of computer technology (i.e. Meditech, Epic), Electronic Health/Medical Record systems, and other relevant third-party technology tools.
  • Knowledge of vendor management and contract negotiation.
  • Knowledge of healthcare regulatory requirements for Medicare with direct data entry (DDE) and return to provide (RTP) and Medicaid and billing compliance for all government payers and managed care contracts.
  • Experience with PPT, Word, Excel, custom reporting such as Tableau and other systems.
  • Collaborative, collegial leader with strong communication skills.
  • Analytical and results oriented.
  • Experience managing projects preferred.
  • A commitment to continuous learning shown through membership in professional organizations like HFMA, MGMA and/or relevant industry standard certifications a plus.
About Us

About Stamford Health

Stamford Health is a non-profit independent health care system with more than 3,800 employees committed to caring for the community through a wide range of high-quality health and wellness services. Patients and their families receive expert, compassionate care through the system's 305-bed Stamford Hospital; Stamford Health Medical Group, with more than 40 offices in lower Fairfield County offering primary and specialty care; a growing number of ambulatory locations across the region; and support through the Stamford Hospital Foundation.

Stamford Health is known for its expert, person-centered care through its many recognitions and partnerships. U.S. News & World Report has recognized Stamford Hospital as a High-Performing Hospital. The Centers for Medicare and Medicaid Services (CMS) rated Stamford Hospital as a five-star hospital for Overall Quality and The Leapfrog Group awarded Stamford Hospital an "A" for patient safety. The American Nurses Credentialing Center has granted Stamford Hospital Magnet Status, which recognizes superior patient care with the highest level of safety, quality, and patient satisfaction. Stamford Health is Planetree Gold-Certified for Excellence in Person-Centered Care and is a CertifiedTM Great Place to Work.

Stamford Health is a major teaching affiliate of the Columbia University Vagelos College of Physicians and Surgeons and has recently expanded its relationship with Columbia to offer treatment and expertise from Columbia University Irving Medical Center's nationally recognized heart surgeons. Stamford Health and Hospital for Special Surgery (HSS) have created a premier center for specialty orthopedic care right in Stamford, Connecticut. Additionally, in 2020 Stamford Health's Carl & Dorothy Bennett Cancer Center entered into an expanded collaboration with Dana-Farber Brigham Cancer Center.

Dedicated to being the community's most trusted health care partner, Stamford Health puts patients first to build long-lasting relationships. For more information, visit Like us on Facebook and follow us on Twitter, Instagram, YouTube, and LinkedIn.

About the Team

Why work for Stamford Health?

Stamford Health offers an extremely competitive salary with generous shift differentials where appropriate.

Our Total Rewards Program is ranked as one of the highest satisfiers based on our employee engagement surveys.

With over 100 transfers and promotions each year for the past 5 years, Stamford Health is a place for you to grow and develop your career. Many departments from Nursing to Information Systems and Rehabilitation have Career Ladder programs that foster career development.

Whether employees choose to live in the greater Stamford, CT area or commute from New York or Fairfield, we offer free convenient parking and free transportation from the Stamford train stations.

Our collaborative with Hospital for Special Surgery, and the Dana Farber Brigham and Women's Cancer Care Collaborative, connect us directly with world class expertise, research, resources and technology to put us at the forefront of patient care.

We have a robust Professional Development and Organization Development program that provides both clinical and non-clinical staff with the opportunity to develop and grow professionally.

For organizational leaders, we offer a comprehensive New Manager Orientation four times per year. Our program designed specifically for Stamford Health will help prepare today's and tomorrow's leaders for success with an innovative curriculum based on best practices. It will also enhance the skills of our leaders that bring their fresh leadership perspective from other organizations.

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