Revenue Cycle Director – Full Time – Posted on 8/4/2017 – #242017
Internal and External candidates may apply at www.thayercountyhealth.com – click on Careers
Thayer County Health Services, Thayer County, NE
POSITION SUMMARY: This position is responsible for strategic alignment, management, and daily oversight of the organization’s revenue cycle functions including patient access, patient billing (including claims production), health information management (including coding), insurance follow-up, self-pay collections, cash receipts/adjustments (including administrative, bad debts, and charity care), compliance with third party payer regulations, insurance verification and provider enrollment/credentialing. The success of this position will be measured by improvement in key revenue cycle indicators such as: A/R days – gross, cash collections, bad debt expense percentage and provision for charity care percentage, denial percentage, and percentage of accounts over ninety (90) days old. This individual should have comprehensive knowledge of revenue cycle operations, either from a provider or payer perspective, with particular experience in performance improvement identification/implementation and monitoring controls. This position is responsible for personnel development, implementing and maintaining department policies and procedures, and initiating disciplinary action according to policy. This position ensures that the highest standards for the protection of confidential information which includes the security and integrity of the electronic health records. This position also serves as the Chief Privacy Officer who oversees all activities including the development, implementation, and maintenance of all policy and procedures to assure compliance with the Health Insurance Portability and Accountability Act of 1996.
SHIFT: Exempt Full Time SUPERVISION: Reports to the Chief Financial Officer.
• Bachelor’s degree required, preferably in Business or Healthcare Administration (extensive experience and a successful track record in Revenue Cycle Management would be considered in place of a Bachelor’s degree)
• Master’s Degree in a related field preferred (MBA, MHA)
• Five years of progressive Revenue Cycle Management experience required (either Health Information or Patient Financial Services or both)
• Relevant industry license/certifications preferred (CRCE, CRCP, CPAM, CRCR, CHFP or RHIT)
• Participation in relevant industry professional associations preferred (AAHAM or HFMA)
• Experience with Critical Access Hospitals and Rural Health Clinics required
• Successful history working with Medicare/Medicaid payment plans and regulations
• Intermediate computer skills in Microsoft Office, with preferred experience in Cerner EHR system
• Knowledge of CPT, HCSPCS, ICD-10 coding, revenue codes, & hospital/physician billing (claims processing)
• Demonstrates highly developed verbal and written communication skills, excellent analytical and problem solving skills, the ability to assess and evaluate complex financial data, and the ability to manage multiple complex tasks
• Exhibits excellent leadership and self-direction, good judgment in handling difficult situations and good organizational, time management, interpersonal and conflict resolution skills
• Ensures accounts are billed accurately and timely by providing proactive oversight and direction for patient registration, billing, and collections, including but not limited to: inpatient, outpatient, emergency room, clinic, lab, rehab, and home health procedures/visits
• Provides operational oversight for Patient Access Team Lead and Billing Team Lead, mentoring them in their responsibilities
• Maintains current knowledge of hospital billing systems and government payment systems, including applicable federal/state laws and regulations, as well as all aspects of third party reimbursement policies and practices
• Develops and implements HIM and Patient Access/Patient Accounting policies and procedures in accordance with applicable laws, regulations, and sound business practices
• Demonstrates ability to supervise, train and motivate employees, as well as a professional attitude in relating to executive management, professionals, third-party insurance carriers, and business/community leaders
• Organizes and leads intra-departmental efforts to maximize operational efficiency and optimize reimbursement, as well as monitors denials and provides education and reporting to clinical areas regarding the effect of denials from their area
• Selects and monitors outside collection and “early out” vendors engaged in the collection of accounts receivable, reviews and balances agency reports to hospital system reports, and approves agency invoices
• Assures that confidentiality of patient information is maintained without exception and satisfactorily handles customer complaints within organization guidelines
• Attends all required meetings and activities, maintaining a professional affiliation to stay abreast of current trends and changes in legislation and industry best practices
• Develops and implements Privacy Policies in compliance with the Health Insurance Portability and Accountability Act.
• Develops and implements departmental budget(s).
• Develops departmental objectives and goals in addition to organizing the work load with staff.
• Interviews/hires all staff in addition to performing performance evaluations and recommended wage increases, promotions, or disciplinary actions.
• Prepares statistical analysis and reports to mandatory agencies.
• Prepares the Medical Staff Meeting agenda, attends meetings, and acts as recorder.
• Actively participates in revenue cycle improvement activities.
• Audits records and works closely with staff to assure the completeness of the electronic health record.
• Audits electronic health records to assure compliance with access in accordance with the privacy regulations and performs initial and periodic information privacy risk assessments.
• Manages and oversees transcription services.
• Oversees or ensures delivery of initial privacy training and orientation to all employees, volunteers, and contracted employees.
• Develops and implements all business associate agreements in accordance with the privacy regulations.
• Accurately assigns diagnosis and procedure codes to hospital inpatient visits, outpatient surgeries and emergency room visits.
• Accurately assigns professional fee to hospital and emergency room visits.
• Performs all Quality Improvement activities for the department(s).
• Performs quarterly audits of accounts for coding performance.
• Performs all other duties as assigned