Director of Revenue Cycle

Company: CMU Health
Location: Saginaw
Posted on: May 16, 2023

Job Description:

The Director of Revenue Cycle leads the system-wide coordination and optimization of the revenue cycle and plays a critical role in the financial development and growth of CMEP. The Director champions revenue cycle operations improvement at all levels throughout the organization and is responsible for all revenue cycle related functions including Insurance Verifications and Authorizations, Denials, Credentialing, Education, Patient Access and Patient Financial Services. Overall, this role oversees all of revenue cycle staff, processes and technology that support all locations and payors and ensures maximum collection efficiency while creating a culture of accountability and service to our patients.Directs unit activities and operations ensuring timely, accurate and customer friendly services, as well as setting goals using industry benchmarks to drive best practice performance. Meets with leadership and staff weekly to ensure successful department operations.Implements and sustains routine auditing processes and reports findings as appropriate. Identifies billing errors and follows-up with staff members/third party payers to ensure resolution.Develops, implements, and publishes scorecards capturing key performance indicators.Conducts analysis of statistics to help identify and implement remediation plans.Actively manages technology and vendor performance, outcomes and relationships ensuring expected outcomes are met and/or real time decisions to ensure best practice performance.Develops and implements risk assessment tools to identify areas of potential liability related to professional medical record documentation practices, charge capture mechanisms, coding efforts and billing activities.Develops and implements clinician-training programs where necessary in areas such as procedural documentation practices, compliance with teaching physician rules, and a control plan to sustain such practices.Oversees the development of educational tools to assist providers in documentation efforts, specifically targeting challenging areas for billing compliance.Recommends modifications to overall billing compliance efforts to enhance effectiveness. Establishes goals and objectives for the unit; develops policy and practices, procedures for compliance and auditing activities; directs and controls both the technical and administrative functions.Preparing an annual budget; scheduling expenditures; analyzing variances; initiating corrective actions.Updates job knowledge through educational opportunities; reading professional publications; participating in professional organizations.Identifies opportunities for process improvement and automation by recognizing issues based on changes in patient inquiry trends. Provides timely feedback to peers in operational areas and leadership to improve revenue cycle processes. Participates in process improvement initiatives throughout the entire revenue cycle operation.Leadership/ManagementProvides direction and accomplishes results through team.Managesthe staffing and deployment of assigned resources.Overseesemployee learning and development needs.A BS in operations management, finance, business administration or related field is required; a graduate degree strongly preferred7-10 years progressive management experience in healthcare revenue cycle operations required, including experience hiring, training, evaluating, discipline, developing and engaging staff members. Academic medical experience preferred.Five (5) plus years of strong leadership experience supervising 20 plus employees.Operations subject matter expert for RCM workflows and must be able to communicate to executive and local leadership teams strategies for collection efficiency. Demonstrated knowledge of federal programs affecting quality monitoring, payment and incentives that flow through the revenue cycle.Demonstrated skills in working with external regulators and private payers in resolving audits in an appropriate and expedient manner.Experience tracking and analyzing data and implementing process improvements required.Must be an employee focused with exceptional people and service skillsMust be detail-oriented and organized, with good analytical and problem-solving ability.Ability to function independently and as a team player in a fast-paced environment required.Must have exceptional written and verbal communications skills.CREDENTIALS, LICENSURE OR CERTIFICATIONCCS, CPC or equivalent coding certificate preferredCertification and/or Fellowship in the Medical Group Management Association strongly preferred OTHER DUTIESPlease note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.CMU is an AA/EO institution, providing equal opportunity to all persons, including minorities, females, veterans, and individuals with disabilities.

Keywords: CMU Health, Saginaw , Director of Revenue Cycle, Accounting, Auditing , Saginaw, Michigan