DIRECTOR OF REVENUE CYCLE

Position Summary

The Director of Revenue Cycle is responsible for planning, supervising and evaluating the daily operations of the Central Business Office in accordance with established business objectives and applicable regulatory requirements. The incumbent continuously monitors work queue volumes and productivity as well as the accuracy and timeliness of work results to ensure compliance with internal policies/procedures and customer satisfaction standards. Work is also strongly focused on developing and maintaining strong relationships with hospital and clinic leadership/staff and providers to foster effective two-way communication/feedback and provide guidance/training to improve revenue cycle processes and results. Work is performed in accordance with established standards/guidelines and requires knowledge of applicable regulatory requirements sufficient to ensure compliant operations and to exercise judgment and critical thinking in addressing operational and/or regulatory issues. Also requires expertise in supervising and evaluating the supervisory staff.

Principal Duties and Responsibilities

The following section contains representative examples of job duties that might be performed in positions allocated to this job class. Union General Health System is a dynamic organization, and the environment can be fluid. Roles and responsibilities may be altered to accommodate changing business conditions and objectives as well as to tap into the skills and experience of its employees. Accordingly, employees may be asked to perform duties that are outside the specific work that is listed. It is not required that any position perform all duties listed, so long as the primary responsibilities are consistent with the work as described. Performance standards developed for incumbents allocated to this job class may also contain relevant job content information and are referenced hereto.

• Provides leadership and direction to the Central Business Office Supervisors.
• Continuously strives for excellence resulting in overall operational effectiveness and excellent revenue cycle performance through daily management of the Key Performance Indicators.
• Serves as critical conduit/liaison with various internal departments/external payers to coordinate and/or troubleshoot various revenue cycle-related issues.
• Applies solid critical thinking skills to troubleshooting, problem-solving, resolving errors/problems and appropriate escalation of issues to higher-level management.
• Identifies opportunities to streamline current operations, implementing approved procedural/process changes, and maintaining/updating guidelines, tools and related materials specific to assigned revenue cycle function.

Position Qualifications

Education

• High School Diploma or GED equivalent is required.
• Bachelor’s Degree in related field is preferred – experience in lieu of education may be substituted

Experience

• Five years supervisory experiences required
• Seven years Billing / AR – Denial Management with hospital and/or professional claims which demonstrates attainment of the required requisite job knowledge and abilities.
• Demonstrated knowledge of Federal / State Regulations and commercial insurance guidelines, payer contracts, and basic medical terminology and abbreviations

Knowledge, Skills, Abilities

• Proficient in Microsoft Office products, specifically Excel
• Proven leadership skills and ability to gain cooperation and support from a diverse body of individuals
• Highly dependable in both production and attendance
• Ability to effectively prioritize and execute tasks while under pressure; make decisions based on available information and within the scope of authority of the position; excellent customer service skills, including professional telephone interactions.
• Exceptional organization, problem solving, and time management skills with an attention to detail
• Excellent verbal and written business communication skills sufficient to clearly document issues and effectively communicate.
• Promote the mission, vision, and values of Union General Health System.
• Maintain confidentiality of all patient, medical, financial, and legal information.
• Represent the organization in a positive & professional manner.
• Ability to handle difficult situations involving patients, physicians, staff and others in a positive and professional manner.
• Comply with all organization policies and standards
• Consistently demonstrate the value of team concept.
• Understands and abides by OSHA, HIPAA and CLIA standards
• In-depth understanding of HIPAA regulations and proven ability to ensure confidentiality with respect to sensitive information