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Senior Vice President of Pre-Billing Operations

2 months ago

Nashville, Tennessee, United States Envision Healthcare Full time
Job Overview

The Senior Vice President of Pre-Billing Operations is tasked with the comprehensive management of various Service Lines. Key responsibilities encompass Chart Entry, Verification, Reconciliation, Clearing House Rejections, and Front End Denials. This role emphasizes identifying root causes and spearheading ongoing process enhancements across all areas of responsibility, ultimately aimed at boosting revenue, enhancing cash collections, and minimizing collection costs. This position is remote with travel requirements of up to 35%.

Company Overview: Envision Healthcare stands as a prominent national medical group dedicated to providing exceptional care to patients at their point of need. Our clinicians and clinical support professionals are dispersed nationwide, embodying a diverse range of backgrounds that reflect the rich tapestry of our communities.

Benefits: At Envision Healthcare, we prioritize your well-being with a comprehensive suite of health and welfare benefits tailored to your needs and those of your family. Eligible employees can enroll from day one, ensuring immediate protection for you and your loved ones. Our benefits package includes, but is not limited to: Medical, Dental, Vision, Life, Disability, Healthcare FSA, Dependent Care FSA, Limited Healthcare FSA, FSAs for Transportation and Parking, and HSAs.

Paid Time Off: We offer generous paid time off, including 9 observed holidays and paid family leave. Employees accrue Paid Time Off (PTO) with a minimum of 20 days and up to 25 days per calendar year, depending on their position.

Key Responsibilities:
  • Oversee the complete workflow process following the SBC process, managing all verification, coverage, and reconciliation tasks for Pre-Billing, including Front End Denials. The VP will also focus on continuous improvement of Service Line Payor Rejections.
  • Project workload and operating expenses based on anticipated volume.
  • Prepare annual operating and capital budgets, concentrating on cost reduction and revenue enhancement.
  • Monitor and manage labor costs, inventory levels, and production planning across all departments, optimizing productivity while minimizing unnecessary expenses.
  • Lead initiatives to develop innovative strategies for streamlining processes, reorganizing workflows, implementing modern technologies, and enhancing resource utilization to drive efficiencies and positively impact KPIs.
  • Ensure that training and quality standards are consistently improved.
  • Establish and enhance quality benchmarks across all Service Lines.
  • Develop and refine monitoring systems to communicate essential financial indicators.
  • Collaborate effectively with other leaders to improve processes across the revenue cycle.
  • Oversee departmental investigations and resolutions related to client billing issues of varying complexity.
  • Accountable for the performance of pre-billing departments, including staffing, budgeting, and operational improvements.
  • Participate in lead committees as assigned.
  • Maintain knowledge of current Billing Compliance Policies, Payor Policies, and Governmental Regulations to ensure adherence.
  • Foster collaborative relationships with other departments to enhance communication and achieve patient collection goals.
  • Develop and adhere to departmental staffing, revenue, and expense budgets, adapting to business changes that may impact budget goals.
  • Manage a team of Directors and staff, focusing on their professional development and fostering a culture of collaboration and growth.
  • Oversee the hiring, training, assignment of work, performance evaluation, and professional development of team members.
  • Strategize on optimizing vendor management, including innovative technologies to enhance efficiencies and maximize returns on investment.
  • Conduct ongoing quality reviews for both offshore and onshore staff and vendors to promote continuous improvement across the Revenue Cycle.
Qualifications:

To excel in this role, candidates must demonstrate proficiency in the following areas:

Education/Experience:
  • Bachelor's Degree in Business, Accounting, Healthcare Management, or related fields is required; an MBA is preferred.
  • A minimum of five (5) years of management experience at the Director level in Part B reimbursement, healthcare, or the medical insurance sector is required.
  • Strong understanding of hospital operations, physician third-party reimbursement, regulatory compliance, and practice management activities is essential.
  • Experience with EMHM, particularly in Anesthesia operations, is preferred.
  • Managerial experience in a high-volume transaction-oriented business is advantageous, along with strong administrative and budgetary skills.
  • Proven success in enhancing patient collections through innovative approaches and effective management of vendor relationships.
  • Excellent organizational, interpersonal, and communication skills, both verbal and written.
  • Demonstrated ability to thrive in a high-volume, fast-paced environment across multiple service lines.
Knowledge & Skills:
  • Understanding of patient care issues, required documentation, and common challenges in treatment and billing.
  • Familiarity with Medicare/Medicaid regulations and other government payor rules, as well as a high-level understanding of Payor Policies.
  • Knowledge of medical and insurance industry terminology.
  • Fluency in front-end Hospital Operations, including registration, physician documentation, and billing/collections.
  • Awareness of HIPAA, Sarbanes-Oxley, and other critical regulations.
  • Expertise in regulatory compliance and auditing practices.
  • Understanding of Healthcare Management principles and practices.
  • Proficiency in budgeting, accounting, and financial analysis tools and principles.
  • Knowledge of Payor enrollment and payment processes.
  • Ability to plan and execute the consolidation of business operations during acquisitions.
  • Experience in continuous process improvement of front-end billing operations.
  • Ability to inspire and motivate teams to foster a culture of continuous improvement.
  • Skill in analyzing and communicating issues, challenges, and solutions across departmental boundaries.
  • Advanced analytical skills to support process enhancements.
  • Experience leading inter- and intra-departmental teams in complex projects.