Revenue Cycle Director - Full Time

If you are interested please apply online and send your resume to anjimenez@mlkch.org

POSITION SUMMARY

Under direction of the Chief Financial Officer or his/her designee and based on reports, audits, patient accounting system queries and reviews and other indicators, provides assistance to the monitoring of outsourced Revenue Cycle contract(s).  Reviews reports, accounts receivable aging, bill hold reports, denial reports, and other key indicators and assists in the development of  action plans/recommendations and responses to improve Revenue Cycle operations. The Revenue Cycle Director will also be responsible for development and execution of Revenue Cycle program initiatives, will work closely with stakeholders across the broader Martin Luther King Jr Community Hospital/ Medical Group organization to drive operational and strategic changes. Assures that key elements of Revenue Cycle outsource contract process are working and that MLKCH is receiving best value and services for all contracts.  Identifies weaknesses, deficiencies and recommends solutions. 

ESSENTIAL DUTIES AND RESPONSIBILITIES

1. Ensures all proper and accurate documents are received, documented, and coded by outsourced Revenue Cycle provider in a timely manner.
2. Manages the Charge Reconciliation process to ensure that all appropriate charges are captured.
3. Troubleshoots and audits documentation and billing process to ensure accuracy, timeliness, and completeness in conjunction with billing group(s). 
4. Collaborates with Contractor Representatives to develop a meaningful agenda for the monthly meeting of the Revenue Cycle Committee for all outsourced Revenue Cycles.
5. Provides input into policies and procedures as it relates to Revenue Cycle functions / billing.
6. Provides ongoing staff guidance on billing compliance issues.
7. Provides program leadership for large strategic and cross-functional workflow initiatives by defining project scope, engaging stakeholders, and managing project timelines and deliverables. 
8. Builds positive working relationships across the organization; engages effectively with staff, management, and senior leadership in project work.
9. Assists in the development and maintenance of statistical and reports as needed. Guides in identifying program initiatives in alignment with Revenue Cycle strategic objectives.
10. Participates actively in strategic committee discussions and activities and takes a leadership role in organizing projects or initiatives to support committee aims.
11. Assists in the development of executive-level presentations for senior leadership. Delivers presentations on Revenue Cycle programs and initiatives to a variety of audience levels. 
12. Performs financial and operational data analysis in support of organizational and project-level objectives. 
13. Serves as a Revenue Cycle methodology expert, consulting within and outside of the Revenue Cycle department on Revenue Cycle best practices.
14. Trains other staff as needed.
15. Regularly review all key components of billing group(s) contract process and performance through review of dashboards, reports, queries, and other tools. 
16. Monitors timely and accurate registration, billing, coding, and follow up through reporting metrics and other analytical tools.
17. Interfaces with key Revenue Cycle stakeholders including clinical and operational leadership to identify workflow issues and barriers to an effective Revenue Cycle process and recommends and helps implement solutions.
18. Works with information technology resources and operational leadership to identify E.H.R. related workflow issues that impact the effectiveness of Revenue Cycle processes; identifies and helps implement solutions.
19. Reviews and monitors all Revenue Cycle interfaces between hospital and outsourced Revenue Cycle provider(s) services.  Identifies workflow issues and barriers to an effective Revenue Cycle process for outsourced Revenue Cycle provider and recommends and helps implement solutions. 
20. Reviews patient accounts (account notes, billing and collection work, etc.) on a detail level to assure that timely follow up is being performed by outsourced Revenue Cycle provider(s).  Provides feedback to management.
21. Reviews and audits contractual write-offs and denials by outsourced Revenue Cycle provider(s). Identifies reimbursement problems. Provides feedback to management on reimbursement variations.
22. Resolve and troubleshoots patient concerns and questions. 
23. Other duties as assigned.

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POSITION REQUIREMENTS

A.   Education

• Bachelor's degree in business administration, finance, or related field preferred
• Or equivalent years of experience in healthcare Revenue Cycle management

B.  Qualifications/Experience

• 5-10 years of experience leading/ managing healthcare Revenue Cycle departments
• Recent experience in Revenue Cycle system implementation
• Strong understanding of all elements required for billing (coding, registration, charging, etc.)

C.   Special Skills/Knowledge

• In-depth understanding and knowledge of all elements of healthcare Revenue Cycle process
• Ability to act as a thought leader for performance improvement and Revenue Cycle methodologies
• Current knowledge of Medicare/ Medi-Cal/ Medicaid billing requirements and guidelines
• Current knowledge and recent experience of Cerner E.H.R., especially the Revenue Cycle components (HIM, charging, billing, follow up, etc.) preferred
• Ability to communicate effectively at all organizational levels, both orally and in writing 
• Ability to establish and maintain effective relationships with widely diverse groups, including individuals at all levels both within and outside the organization 
• Ability to motivate, influence, and direct the work of others 
• Ability to resolve conflicts and/or negotiate with others to achieve positive results 
• Ability to work well both autonomously and as a team player 
• Flexible and adaptable to change while working in a fast-paced environment. 
• Demonstrated quantitative analytical skills 
• Demonstrated organization and planning skills 
• Demonstrated knowledge and understanding of Lean, project management, and/or Six Sigma principles and their applications 
• Demonstrated familiarity with and understanding of Microsoft Office applications (Excel, Word, PowerPoint, Visio, Outlook)