Healthcare Revenue Cycle Director

Job Summary:
Directs ambulatory revenue cycle activities from coding through account resolution.

Enhances the current coding, billing and collections functions by establishing strategic goals and a comprehensive work plan to achieve industry-leading revenue management performance.

This includes the development, implementation and management of standardized coding and billing practices, which are consistent with industry best practices.
Primary Duties:
1.

Provides direction and support to EvergreenHealth Professional Coding and Professional Billing departments.

Establishes professional coding and billing targets and operational benchmarks.

Monitors and reports on performance against those targets on a routine basis.

Implements strategies to meet desired objectives.

This includes monitoring and evaluating programmatic and operational effectiveness and implementing programs to improve professional coding and billing processes.

Maintains current knowledge in reimbursement, billing procedures and requirements of major third-party payers.

Assesses and responds to organizational and customer needs with innovative programs to ensure customer satisfaction.

Maintains a comprehensive knowledge of payor policies and procedures and remains current on regulations affecting the professional coding and billing function.

2.

Serve as a point of contact for ambulatory revenue cycle vendor relationships: Assesses third party applications and determine best in class vendors that benefit EvergreenHealth.

Provides leadership in the continued development and implementation of new software systems and applications to facilitate more effective ambulatory revenue cycle operations, reporting and decision-making.

Negotiates preferred pricing with best in class third party vendors to achieve cost savings to EvergreenHealth and our system affiliates.

Develops appropriate reporting tools to measure and monitor the success of our preferred vendors.

Oversees and serves as a primary point of contact with the self-pay outsource vendor and collection agencies.
3.

Develops and refines reporting to measure the effectiveness of the ambulatory revenue cycle function.

Utilizes this data to assist in the communication of revenue management performance with ambulatory division leadership and other key stakeholders.

Meets regularly with ambulatory division leadership and clinic administrators.

Ensures that billing issues (internal and patient identified) are properly investigated, documented and resolved.

Prepares ad hoc reporting, as necessary, to investigate billing questions/concerns.
4.

Identifies opportunities for operational improvement by comparing current professional coding and billing operations performance to industry best practices.

Develops action plans in collaboration with key stakeholders to implement change.

Identifies and implements opportunities to enhance the collection process to reduce write-offs and improve collection rates.

5.

Creates, monitors and maintains a positive patient experience: Utilizes industry resources to create a consistent and positive ambulatory revenue cycle patient experience throughout EvergreenHealth.

6.

Fiscal responsibility and budgets: Provides oversight on the monthly analysis of actual expenses as compared to budget.

Communicates significant variances to Executive Director, Revenue Cycle each month that includes but is not limited to plans on staffing, staff development, and productivity improvements.

Regularly provides productivity updates and reallocates resources as necessary to reduce financial risk and enhance patient experience.

Continually evaluates revenue cycle expenses and enhances customer service
7.

Develops annual Professional Billing and Professional Coding department budgets to ensure appropriate allocation of resources to support operations and to meet departmental goals.

Manages operational budget, including operating expenses and staff levels, to meet productivity targets and timelines.

Recommends future expenditures in the areas of staffing levels, investment in new technology, and enhanced staff education.

These recommendations will include ROI estimates or other justifications for expenditures.
8.

Works collaboratively with key stakeholders, including the Ambulatory Division Financial Officer, to establish staffing levels, productivity targets, and quality measures that meet the performance needs of the organization.

Recruits, interviews and selects staff in collaboration with Human Resources and within designated staffing benchmarks.
9.

Develops key relationships with EvergreenHealth leaders: Develops and builds trust, rapport, credibility, confidence and fosters effective collaboration & communication among multiple constituencies including revenue cycle, administration, information technology, finance, human resources, departmental leadership & staff within & across EvergreenHealth.

Works with ambulatory leadership and management teams on creating the best service excellence culture for EvergreenHealth Medical Group.

This includes the implementation of service standards, performance measurement and management/staff training.

Works closely with system affiliated hospitals and clinics, senior management and department leadership in coordinating ambulatory revenue cycle processes and developing collaborative solutions to nurture clinical programs and goals.
10.

Fosters positive team collaboration and staff development to facilitate efficient operations, employee engagement and achievement of patient satisfaction and employee engagement goals.

Develops and maintains collaborative relationships with physicians, clinic administrators, compliance, revenue cycle and finance leadership.
Minimum Qualifications
License, Certification, Education or Experience:
REQUIRED for the position:

• Bachelor’s degree in Healthcare, Business or related field

• 5 years management experience in ambulatory billing and coding or related field

• Ability to communicate both in writing and/or verbally with people under their supervision as well as other department managers and the public
DESIRED for the position:

• Master’s degree in Healthcare, Business or related field
PM21
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PI139666571