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Director Revenue Cycle

3 months ago

Pawleys Island, South Carolina, United States Tidelands Health Full time

Employee Type:
Regular
Work Shift:
Day - 8 hour shift (United States of America)

Join Team Tidelands and help people live better lives through better health

POSITION SUMMARY:

The Director, Revenue Cycle works independently and in support of the VP Revenue Cycle to facilitate a robust back-end revenue cycle program for the Health System. Directly manages leaders in the areas of Accounts Receivable, Billing and Follow-up, Cash Posting and Reconciliation, Vendor Management and Denial Management.

ESSENTIAL FUNCTIONS:

  • Serves as the leader for back-end revenue cycle functions for the Tidelands Health organization. Through the Billing and Follow-up department leadership, ensures that services are appropriately and timely billed to payers and then appropriately and timely followed-up for payment.
  • Through the Cash Management department leadership, ensures that all payments are appropriately and timely posted and reconciled. Collaborates with financial accounting, treasury, and operational leadership to establish policies, procedures, and processes to facilitate the understanding and actions needed throughout the organization to achieve proper cash management. Collaborates with recruiting, medical staff office, payer enrollment, and managed care to ensure all providers and facilities are enrolled for electronic payment.
  • Oversees the work of the Clinical Denials Analyst and facilities cross-functional meetings to continually address and reduce payer denials. This requires the development of routine reporting and feedback throughout the revenue cycle and to operational leaders including providers.
  • Manages vendor relationships for outsourced services within the revenue cycle. Establishes and monitors performance metrics through routine reports and meetings with vendors. Collaborates and partners with the leaders in Revenue Integrity, Managed Care, and Payer Enrollment to facilitate efficient and effective communication with the payers to optimize contract terms and ensure appropriate payment for services provided. In collaboration with the VP of Revenue Cycle, SBU/CSC Leaders, Revenue Cycle Informaticists and data analytic resources, establishes and monitors routinely (daily, weekly, monthly, or as required) KPIs that drive for top decile performance in back-end revenue cycle metrics (AR Days, Final Denial Rate, Clean Claims rate, etc.)
  • Foster a culture of continuous improvement in revenue cycle operations through education of revenue cycle regulations, rules, policies, and procedures.
  • Travel as necessary across the system to clinic and other operational sites to perform required tasks. Perform other duties as assigned.
REQUIRED/MINIMUM QUALIFICATIONS:

EDUCATION: Bachelor's degree or equivalent combination of education and experience in hospital revenue cycle.

EXPERIENCE: At least 5 years working in a health system; experience in revenue cycle operations necessary

LICENSURE/CERTIFICATION:

KNOWLEDGE/SKILLS/ABILITIES:
  • Ability to lead meetings, prioritize, resolve conflicts, maintain issues lists and follow a project plan required
  • Competent in Microsoft Office required
  • Strong verbal/written communication and follow up skills required
  • Strong listening and interpretation skills required
  • Knowledge of the regulatory requirements for health system revenue cycle
  • Ability to lead and mentor application teams required
  • Ability to work independently and collaboratively required
  • Experience in change management preferred
PREFERRED QUALIFICATIONS:

EXPERIENCE: Bachelor's degree and 5 years of progressive experience in revenue cycle leadership including billing, follow-up, cash management and denials management.

LICENSURE/CERTIFICATION: Certified Revenue Cycle Representative or equivalent certification

KNOWLEDGE/SKILLS/ABILITIES:
  • Ability to lead meetings, prioritize, resolve conflicts, maintain issues lists and follow a project plan required
  • Competent in Microsoft Office required
  • Strong verbal/written communication and follow up skills required
  • Strong listening and interpretation skills required
  • Knowledge of the regulatory requirements for health system revenue cycle
  • Ability to lead and mentor teams required
  • Ability to work independently and collaboratively
  • Experience in change management preferred
  • Experience in developing job aides and training materials
  • Strong experience in interfacing with insurers
  • Accounting/treasury knowledge for cash reconciliation
FUNCTIONAL SUPERVISION:
  • Position will be interacting across the organization throughout the Revenue Cycle with mostly indirect supervision.
  • Position will be integral in the ability of personnel throughout the Revenue Cycle to understand and support patient financial needs.
Physical Requirements: Light Physical Agility Test (PAT) Rating

While performing the duties of this job, the employee is frequently (activity or condition exists from 1/3 to 2/3 of the time) required to stand, sit, and walk; frequently to use hands, fingers; and frequently to talk or hear. The employee must exert up to 15 pounds of force occasionally (activity or condition exists up to 1/3 of the time), and/or up to 5 pounds of force frequently, and/or a negligible amount of force constantly to move objects.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

Tidelands Health is an equal opportunity employer (EOE). Tidelands Health does not discriminate against employees or applicants for employment on the basis of race, color, creed, religion, age, national origin, disability, marital status, veteran status, gender, genetic information, familial status, or any other legally protected status.