Senior Director, Revenue Cycle Management

2 weeks ago

Cincinnati, United States Mayfield Brain and Spine Full time
Job DescriptionJob Description

Education/Experience:

  • Bachelor’s degree – healthcare, accounting, or finance required.
  • Minimum of seven years’ work experience within healthcare revenue cycle management.
  • Minimum of five years of demonstrated leadership experience.
  • Well-versed with all federal, state, and HIPAA privacy regulations with thorough CPT and ICD-10 coding protocols and procedures.
  • Demonstrated ability to lead revenue cycle operations strategically and tactically.

Skills:

  • Strong operational and financial management skills.
  • Complex knowledge of the impact of revenue cycle and accounts receivable management upon operating performance.
  • Excellent communications, analysis, process improvement, and customer service skills.
  • Ability to manage people of different temperaments, backgrounds, and educational qualifications.
  • Ability to develop, motivate, and guide team members.
  • Maturity to manage challenging circumstances.
  • Strong problem-solving, problem-prevention, and decision-making skills.
  • Exceptional organizational and time management skills.
  • Proficiency in Word, Excel, practice management systems, and electronic medical records.
  • Forward-thinking capability concerning future technology, process, and human resource changes

Primary Responsibilities:

  • Reporting to the CFO, this role is responsible for all facets of revenue cycle management, including strategy, operations, revenue recognition, and analytics.
  • As part of the Mayfield management team, this role will serve as a key partner in driving the company’s overall revenue cycle strategic direction.

Essential Functions:

  • Help develop, promote, and maintain a corporate culture that supports the mission and values of Mayfield Clinic.
  • Manage the Revenue Cycle Management Department to ensure accurate and timely billing and collection of all services and related recording of charge, payment, and adjustment transactions.
  • Manage the Hospital Services Department to ensure accurate and timely coding and charge posting of all hospital and facility services, including surgeries, ESI’s, minor procedures, and E&M.
  • Manage the denials and appeals processes for unpaid and underpaid third-party claims.
  • Manage the refund and take-back processes for overpaid claims by third-party payers and patients, with approval and processing by Finance.
  • Provide direction to Department staff on problem claims, unresolved account balances, and payer issues.
  • Collaborate with leadership in other revenue-related departments (Access Care, Operations, Information Systems, Finance, etc.) to improve revenue cycle process efficiency and effectiveness.
  • Provide orientation and ongoing Department education and training on (1) Mayfield systems, processes, procedures, and policies; (2) healthcare trends, policies, and issues; and (3) CPT and ICD coding.
  • Manage the recruitment and retention of a high-performing Department workforce in conjunction with Human Resources.
  • Measure Department and associate performance and implement performance improvement and coaching as needed. Complete annual, or more frequently as needed, associate Performance Review and Development Plans on a timely basis. Manage associate termination when appropriate.
  • Maintain knowledge and understanding of relevant business office compliance requirements sufficiently to maintain compliance and identify and resolve issues that arise.
  • Manage the resolution of self-pay balances on a timely basis, including approval of write-offs and discounts and placement of bad debts with collection agencies.
  • Monitor policies and procedures to ensure accurate and complete billing of all services. Develop new forms, policies, and processes as needed. Monitor status in the practice management system to ensure services are billed timely.
  • Periodically review provider E&M coding patterns and report results to the provider and VP of Finance.
  • Manage the daily deposit of satellite and mail receipts and the daily reconciliation of all payments.
  • Maintain applicable system setup tables in practice management systems and related software systems (e.g. insurance carrier tables, payer fee schedules, etc.).
  • Update CPT, ICD10, HCPCS, RVUs, and quality codes in the billing system annually. Update all billing documents for any code changes annually. Update EMR case categories as needed.
  • Create and maintain all coding edits for the practice management system (ie, ACE).
  • Manage credentialing for new and existing physicians and mid-level
  • providers.
  • Act as liaison for third-party payer representatives, billing vendors, and external contacts.
  • Respond to payer audit requests, reviewing and/or compiling chart documents to be sent.
  • Maintain effective working relationships with all Mayfield associates, hospital and referring physician staff, managed care and government payer representatives, and vendor representatives.
  • Manage staffing based on daily activities and workflow.
  • Maintain a high level of customer satisfaction with attention to timely and effective responsiveness.
  • Serve as a revenue cycle resource to physicians, managers, and associates, providing formal and informal education, as needed.
  • Collaborate as a member of the Management Team to establish and implement Mayfield’s strategic plan and manage issues that arise.
  • Manage Department operating and capital expenditures versus budget.
  • Contribute to department and organizational effort by performing other duties as assigned.

Mayfield Clinic Mission:

To provide the best neurological care for our patients through:

  • Superior clinical outcomes
  • Compassionate patient care
  • Education and research
  • Innovation

Mayfield Clinic Values:

All associates who are affiliated with the Mayfield Clinic must agree to use these values as a basis for their employment and recognize that they are part of the associate's annual Performance Review and Development Plan.

  • Integrity: We commit to honest and ethical behavior in all of our endeavors and interactions.
  • Excellence: We commit to the highest level of performance and continuous improvement.
  • Respect: We recognize the worth, quality, and importance of every individual and regard them with consideration and appreciation.
  • Compassion: We commit to being compassionate and empathetic in all of our interactions.
  • Collaboration: We embrace teamwork, mentoring, cooperation, sharing of expertise, and empowerment.

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