Revenue Cycle Operations Director

1 month ago

Montgomery, Alabama, United States Baptist Health Full time
Job Title: Assistant Vice President, Revenue Cycle and Business OperationsAbout Baptist Health

Baptist Health is a leading healthcare system serving central Alabama, providing comprehensive hospital-based and outpatient services to nearly 60 percent of the residents in Montgomery, Autauga and Elmore counties.

Job Summary

The Assistant Vice President, Revenue Cycle and Business Operations is a key member of the Revenue Cycle Services (RCS) leadership team, responsible for driving the financial success of our organization through strategic planning, operational oversight, and collaboration with corporate, facility, and clinic departments.

Key Responsibilities
  • Oversee and manage all aspects of revenue cycle operations, including Patient Access, Central Scheduling, and point of service collections, billing, collecting, coding, and reimbursement.
  • Collaborate with various departments to ensure optimal revenue cycle performance and efficient healthcare operations.
  • Monitor and analyze revenue cycle data to identify trends and areas for improvement.
  • Provide leadership and guidance to revenue cycle team, including setting goals, conducting performance evaluations, and promoting professional development.
  • Foster a culture of continuous improvement and innovation within the revenue cycle and business operations, ensuring compliance with all applicable laws and regulations related to revenue cycle and billing practices.
  • Develop and maintain strong relationships with payers and other external stakeholders to optimize revenue cycle processes and resolve any issues.
  • Serve as a subject matter expert on revenue cycle management and provide guidance and support to other departments and leaders as needed.
  • Prepare and present regular reports on performance, improvement, processes, and KPI tracking for all areas of the revenue cycle and business operations.
  • Collaborate with finance and reimbursement teams to develop and manage revenue cycle budgets and financial forecasts.
  • Participate in organizational committees and initiatives related to revenue cycle and business operations.
  • Represent the organization at external events and conferences related to revenue cycle and healthcare operations.
Requirements
  • Bachelor's degree in acute healthcare or related field, Master's degree in business preferred.
  • Seven years of recent experience in revenue cycle management required.
  • Knowledge of chargemaster, payer contracting analysis, reimbursement variances, and coordination of payer negotiations.
  • Analytic skills needed to drive performance and determine process improvement.
  • Analyze, quantify, and summarize data sets, develop financial models, and work with Finance, Reimbursement, Payer Contracting, and Revenue Cycle Management departments.
  • Develop proposals for payment resolution for claim denials and UR denials regarding long and short-term goals, objectives, and strategies for customer service operations that include Out of Network plans, Marketplace benefits, and Single Case agreements that follow federal and state guidelines.
  • Collaborate with Patient Financial Services and Managed Care to develop proactive solutions for denials management.
  • Coordinate efforts with PFS and Reimbursement to improve Net Revenue projects that include analyzing and trending historical trends and month-end validation.
  • Act as a liaison with IT, Decision Support, Finance, and other departments for Revenue Cycle metrics, systems, and performance.
  • Act as a lead resource in coordinating Revenue Cycle with all the facilities and Physician practices for processes supporting all areas of patient accounting.
  • Work collaboratively with AVP of PFS, AVP of UR and Case Management, and System Directors of HIM & CDI, and Patient Access and Central Scheduling.

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