Senior Director of Revenue Cycle
Company: CRS
Location: Las Vegas
Posted on: May 23, 2023
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Job Description:
Job Summary:The Senior Director of Revenue Cycle Management
reports to the CFO and is responsible for overseeing and
coordinating all revenue cycle activities with a goal of maximizing
reimbursement in a cost-effective manner that is in compliance with
federal, state and payer-specific billing requirements. The Senior
Director will oversee the overall policies, objectives, and
initiatives of our healthcare facilities' revenue cycle activities
to optimize the patient financial interaction along the care
continuum. The Senior Director will focus activities on internal
program operations and collaboration with clinical and operational
leadership. The Senior Director designs a system to support the
patient's financial interface across the continuum of care, using
best practices of cash collection and posting, registration,
insurance verification, billing, and reimbursement principles. -
-Job Duties:-Oversee and support the daily operations of all PFS
functions, including billing, follow-up and collections, cash
posting and all Patient Access areas (Main Registration and ED
Registration).-Work closely with other departments (HIM, Case
Management, Information Technology, Nursing, and Ancillary
departments) to streamline procedures that will help ensure correct
billing to patients and payers in a timely manner, thereby
expediting hospital receivables.-Oversee work schedule and direct
changes in priorities and schedules as needed to assure work is
completed in an efficient and timely manner and to improve the
department's performance and service.-Direct the selection,
supervision and evaluation of staff. Ensure performance evaluations
are conducted in a timely manner according to hospital policy and
initiate disciplinary actions as warranted. Resolve grievances and
other sensitive personnel matters.-Oversee orientation and
continuing education for all staff. Ensure mandatory and relevant
training is provided to staff in a timely manner.-Implement a
Quality Assurance program for PFS functions and monitor staff and
team performance, making changes, when required, to support
accurate billing to payers and patients in a timely manner and
compliance with laws and department procedures.-Establish and
maintain departmental policies and procedures. Communicate relevant
information to other hospital departments. Establish controls and
review mechanisms to ensure procedures are being followed
correctly. Recommend policy changes to the Chief Financial
Officer.-Collaborate with Billing, Collection, and Patient Access
Managers to plan, organize, and deliver regular staff meetings for
the department.-Assist with the development of budgets and
monitoring of department operations to achieve goals within
budget.-Respond personally to concerns and/or complaints expressed
by patients, visitors, hospital staff, and physicians in effort to
support optimal operations and excellent customer service.-Ensure
compliance with relevant regulations, standards, and directives
from regulatory agencies and third-party payers.-Maintain
appropriate internal controls for the safeguarding of cash.-Follow
and monitor compliance with hospital policies and
standards.-Develop, redesign, and monitor key performance
indicators including payer mix, A/R, collection rates, adjustments,
bad debt write off, estimated collections, appeal success rates,
and other requested parameters.-Maintains extensive knowledge of
revenue cycle and regulatory requirements associated with
governmental, managed care, and commercial payers.-Meets and
exceeds short and long term goals as established for the
department.-Serves as the subject-matter expert on regulatory,
compliance, and legal requirements associated with medical billing
and CMS. Ensures compliance with relevant regulations, standards,
and directives from regulatory agencies and third-party
payers.-Develops and maintains internal controls to target revenue
recovery throughout the organizationby identifying charge capture,
coding, and reimbursement problems, then recommending/implanting
solutions.-Monitor A/R effectively and ensure aging categories are
within established goals and national benchmarks.-Responsible for
maximizing the collection of medical services payments and
reimbursements from patients, insurance carriers, financial aide,
and guarantors.-In conjunction with operations, reviews and
enhances insurance verification, coding review,billing, collection,
and payment posting processes for efficiency and best practices;
ensure systems are fully functional and maximized and recommend new
processes to improve current work flow.-Monitors daily productions
of claims, denials, and appeals.-Analyzes claims, utilization, and
medical cost data.-Monitors aged accounts and verifies appropriate
collections procedures are being followed.-Reviews, monitors and
recommends updates to the Clinic's fee schedule to maintain fees at
levels that maximize reimbursement.-Ensures compliance with
relevant federal, state, and payor-specific billing
requirements.-Regularly provides upper management with revenue
cycle status including reports, metrics, and presentation.-Ensure
staff is educated on new technology, goals, and contracts-Establish
a regularly scheduled revenue cycle meeting to discuss strategies
and ensure everyone is educated on the direction of the
department.-Work with Managed Care vendors in identifying any payer
relation issues or contracts that need to be renegotiated or
negotiated for the first time.-Any and all other projects, goals,
issues surrounding the revenue cycle, conflicts or concerns as
directed or indicated by Administration.-Assists in evaluation of
reports, decisions, and results of department in relation to
established goals.-Recommends new approaches, policies, and
procedures to influence continuous improvements in department's
efficiency and services performed.-Actively participates in problem
identification and resolution and coordinates resolutions between
appropriate parties.-Adheres to Corporate, Department and HR
policies and procedures. - -Education and Experience
Qualifications: --Bachelor's degree in Healthcare Administration,
Business, Accounting, Finance or related field and three years of
management-level experience in hospital revenue cycle with
expertise in billing and collections.-Knowledge of Healthcare and
Family Services (HFS) regulations-General computer skills with
working knowledge of word processing, spreadsheet, and email
applications.-Knowledge of third-party billing related activities
for Medicaid, Medicare, and Commercial Managed Care
contracts-Excellent oral and written communication skills to
effectively communicate with customers and all levels of
management.-Seven (7) years of experience in financial management
or administration for an integrated health system-Three (3) years
of experience with third party billing related activities for
Medicaid, Medicare and Commercial Managed Care contracts-Three (3)
years of supervisory and/or managerial experience-Three (3) years
of experience in a safety net or teaching hospital-Advanced
proficiency In Microsoft Office Excel-Project management
experience-Electronic Medical Record experience-Experience in
Program or service implementation and performance improvement
-Physical Requirements:-Employee is required to have visual and
auditory acuity necessary for communications with other employees
and/or customers to meet business needs of the
organization.-Employee must be able to see written documentation
and be able to speak and hear for communication with
employees/customers.-Ability to use a wide array of office
equipment including, but not limited to a PC, copier, fax,
multi-line telephone, etc.-Employee is exposed to general indoor
working conditions and may on occasion require light lifting or no
greater than 20 pounds and some offsite travel.Powered by
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Keywords: CRS, Las Vegas , Senior Director of Revenue Cycle, Executive , Las Vegas, Nevada
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