Director, Front-End Revenue Cycle Management

Description

Company Overview

National Partners in Healthcare (NPH) is a progressive healthcare company specializing in anesthesiology. We partner with physicians and health systems to deliver high-quality care, aligning synergies and best practices to achieve superior outcomes. As a leader in the industry, we believe in developing a foundation of trust, transparency, and excellence in everything we do. The success of our company has created excellent career advancement opportunities that support a healthy work/life balance.

Position Summary:

This position will oversee and direct the front-end revenue cycle activities, initiatives, and strategies, which includes reconciliation, data entry, demographics, insurance verification, coding, billing, system administration, and scanning.   

The Director is responsible for enhancing and maintaining a properly functioning revenue cycle process through a cross-department organizational structure. Critical responsibilities include achieving key performance measures which define revenue cycle performance and both drive and maximize organizational and financial performance.  

The Director is also responsible for ensuring all Department functions, policies and procedures are updated and maintained and aligned with best practice by the Management team. 

Essential Duties and Responsibilities: 

• Provide leadership and direction to Reconciliation Supervisor and Specialists, Coding Manager and Coders, and Charge Entry Supervisors and Specialists. 

• Responsible for front-end functions of the Revenue Cycle, including reconciliation, data entry, demographics, insurance verification, coding, billing, system administration, and scanning. 

• Coordinate activities between departments. Assemble and analyze daily, weekly and monthly reports to ensure proper staffing and workflow in all areas. 

• Motivate and lead a high-performance leadership team; attract, recruit, and retain required members of leadership as needed; provide mentoring as a cornerstone to leadership career development. 

• Responsible for driving the company to achieve and surpass revenue, profitability, cash flow, and business goals and objectives. 

• Develop and monitor all Key Performance Indicator reports, including staff quality and productivity and address concerns as needed. Ensure Manager and Supervisor reports act with a sense of accountability and ownership as it relates to their work streams.  

• Develop and monitor the productivity and quality standards for team members in Reconciliation, Coding, and Charge Entry. 

• Regularly partner with the IT staff/Software Vendor and identify ways to standardize systems and ensure that all IT requests outstanding are managed and resolved in a timely manner.  

• Provide support to VP of Revenue Cycle Management, VP of Operations, and senior leaders regarding goal setting, benchmarking, process development, etc. 

• Partner closely with leaders in the areas of Operations, Finance, Human Resources, Information Systems, Managed Care, and Compliance to achieve business objectives and implement organizational strategies. 

• Partner with VP of Revenue Cycle Management to develop and implement revenue cycle strategy.  

• Responsible for setup, implementation, and on-going maintenance of the practice management system with support from the IT Department/Software Vendor as it relates to front-end revenue cycle management functions. 

• Responsible for working with the RCM Training Q&A Manager to ensure appropriate training and education for all staff members is delivered. 

• Assist in the development of policies and procedures as indicated and requested. 

• Review month-end reports, make assessments of front-end revenue cycleprogress, and escalate to the VP of Revenue Cycle Management, as needed. 

• Generate and summarize reports as requested. 

• Interface and communicate with hospital administration(s), surgeon offices, and staff as needed. 

• Maintain a current knowledge of all applicable federal and state privacy laws and regulations (e.g., HIPAA).  

• Cooperate with the Department of Health and Human Services Office of Civil Rights and other legal entities in any compliance reviews or investigations. 

• Assess and respond to organizational and customer’s needs with innovative programs to ensure customer satisfaction. 

• Adhere to all company policies and procedures. 

• Adherence to and compliance with information systems security is everyone’s responsibility. It is the responsibility of every computer user to: Know and follow Information Systems’ security policies and procedures. Attend Information Systems security training, when offered.  Report on information systems security problems. 

• Mentor employees, conduct performance evaluations, counsel and provide disciplinary actions to assigned personnel, and facilitate individual and team development that drives positive results. 

• Maintain strictest confidentiality. 
• Perform other duties as assigned. 

Qualifications

Education/Licensing/Certification:  

• A bachelor’s degree in business, healthcare, management, or finance major.   

 Experience:  

• Must have a minimum of 5 years’ healthcare revenue cycle management experience. 

• Must have a minimum of 3 years managing high-performing teams 

• Prefer 2 years anesthesia experience. 

Knowledge and Skills: 

• Strong financial management skills, including the ability to financially analyze data for financial reporting, budgeting, forecasting, AR analysis, and staffing analysis. 

• Leadership skills to motivate department performance towards goals and develop team working style. 

• The ability to make a significant contribution to the organization’s overall effectiveness. 

• Knowledge of organization policies, procedures, and systems 

• Good understanding of the revenue cycle 

• Strong analytical and problem-solving skills to identify trends and issues; ability to create solutions to address issues   

• Knowledge of contractual management practices 

• Skill in computer applications including MS Word and MS Excel.   

• Analytical abilities required to identify and resolve coding issues.                

• Ability to work effectively with staff, physicians, and external customers.  Must display teamwork attitude and good inter-personal skills.  

• Must have a pleasant disposition and high tolerance level.   

• Ability to work independently with limited supervision. 

• Familiarity with medical terminology and concepts required 

• Knowledge of CPT, ICD-10, and ASA coding. 

• Excellent listening skills. 

• Strong leadership and management skills. 

• In-depth knowledge of HIPAA. 

• Strong verbal and written communication skills. 

• Ability to motivate diverse personalities. 

• Skill in gathering and reporting information and analyzing outcomes. 

• Must demonstrate maturity and competence in dealing with leaders and staff. 

• General understanding of the functions of all NPH departments. 

• Ability to meet deadlines. 

• General understanding of practice management systems  

• Ability to read, write, and speak English 

• Ability to travel (<10%)