Executive Director of Revenue Cycle

RESPONSIBILITIES
Overall core job responsibility is to plan, direct, and supervise all aspects of the centralized billing functions, including, but not limited to, new and established patient registration, insurance verification, charge entry and reconciliation, payment posting, insurance claims, payer denials, patient statements, refund and credit processing, managing patient and organizational billing questions and concerns, daily and monthly reconciliations, compliance, and reporting of key performance indicators.

Job Specific Competencies:
Oversees all aspects of claims processing, including charge master upkeep, accuracy and compliance with claims filed, maximizing reimbursement, and payment posting.
Maintains the billing system data such as: procedure codes, diagnosis codes, referring providers, appointment scheduling, insurance companies, place of services, etc.
Analyzes revenue cycle data and audits to ensure revenue integrity and compliance with regulations.
Trains the staff on revenue cycle functions.
Oversees and participates, as appropriate, in the interviewing, hiring, and training of personnel for all areas in the department. Completes employee performance evaluations in a timely manner.
Establishes the short-term and long-term plan for the department, including the budget.
Prepares reports, analyzes data, and makes recommendations. Writes specific reports based on requests and needs of the department staff, providers, clinics, and group.
Responsible for implementing any new billing requirements mandated by the insurance companies or government.
Responsible for the setup of new clinics, new providers, and new service lines as it relates to billing process.
Develops and implements new processes and procedures to improve efficiency, effectiveness, and quality of work completed by the department. Ensures procedures are well documented, communicated, and administered consistently.
Ability to identify and communicate issues and concerns and develop effective solutions.
Solves difficult billing cycle issues and works collaboratively with internal and external parties to resolve issues timely.
Develops and oversee practice management systems and works with the Information Systems Department to ensure timely and accurate set up, implementation, maintenance, and efficiencies.
Participates in various internal committees to the extent they are related to the revenue cycle.
Collaborates with multiple departments, providers, and staff regarding billing guidelines, regulations, payment and reimbursement levels, and issues.
Leads proactively and is a visionary who influences, mentors, and holds staff accountable.

JCMG Core Competencies:
Strives for continuous quality improvement.
Participates in educational experiences designed to maintain and/or improve professional competence.
Maintains high work ethic standards.
Provides quality customer service to staff, patients, and visitors.

MINIMUM QUALIFICATIONS
Education:
BA or BS degree

Experience:
Minimum five (5) years of healthcare practice revenue cycle experience
Minimum five (5) years of healthcare management experience

Certification/License:
At least one Revenue Cycle certification, such as Certified Professional Coder Certificate, Certified Revenue Cycle Executive, Certified Specialist Payment and Reimbursement, etc.

Competency in medical terminology as demonstrated by formal training and experience
Knowledge of office procedures, government regulations and billing requirements
Must be able to maintain effective working relationships with staff, co-workers, providers, and patients
Computer literate, knowledge of spreadsheets and other applications