Dir Physician Revenue Cycle

Brown Medicine

2d•Onsite

About The Position

SUMMARY: The Director of Professional Receivables will report to the Vice President of Patient Financial Services. Plans, organizes, and controls all activities and information systems necessary to ensure the effective, timely and accurate accounts receivable and revenue cycle management processes for the Lifespan-affiliated medical practices. Brown University Health employees are expected to successfully role model the organization’s values of Compassion, Accountability, Respect and Excellence, as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate In addition, our leaders will demonstrate an aptitude for: Ensure Accountability and Build Effective Teams Drive Vision and Purpose and Optimize Work Processes By applying core and leadership competencies, leaders help Brown University Health achieve its strategic goals. RESPONSIBILITIES: Implements and maintains billing procedures for all services related to Lifespan’s medical practices. Supports the integration of new physicians/practices and accounts receivable systems to maximize first pass resolution and net collection rates, and improve days outstanding. Ensures the implementation of the overall practice patient accounting functions to include charge entry, billing, follow up, cash application, and self-pay/bad debt functions. Develops and establishes methods to monitor and evaluate effectiveness of contracted patient account - billing services and systems, identifying opportunities for standardization of billing operations and practices. Responsible for ensuring the medical data is secure, accessible, and accurate for billing purposes. Ensures all proper disease classification and procedure (ICD/CPT) coding is used in the billing functions. Focuses practices on issues that will positively impact financial performance. Assesses impact of new regulations or newly established or modified codes from a coding, compliance and reimbursement perspective. Develops expertise for assigned practices. Analyzes receivables in order to solve technical and managerial problems relative to complex plans, systems, and programs. Tracks, trends, and analyzes receivables and associated cash to quickly enable the detection of variations adversely affecting cash flow. Implements and maintains robust reporting systems to ensure that practice management receives and understand productivity quality measures. Responsible for the accurate and timely cash application, including unprocessed cash, obtaining additional information from payers whenever needed. Maintains technical and industry awareness of new product knowledge of cash management, collection systems and trends. Responsible for responding to internal and external audits for the medical practices and the Lifespan Physician Group. Participates in audit process, reviews and direct the implementation of audit follow-up recommendations as required. Ensures that self-pay and bad debt policies are administered consistently and in accordance with established standards for same. Responsible for timely processing of all address corrections to self-pay mail and itemized bill requests. Responsible for providing and communicating expedient resolutions to any patient complaints. Responsible for all department budgets and the implementation of approved systems and processes in support of the delivery of quality patient care, efficient and effective medical practice operations and successful financial performance. Recruits, hires, and trains qualified staff members. Manages and supports administrative and clinical staff, and provides regular feedback about individual and team performance. Communicates regularly with staff members to foster an environment of teamwork and cooperation. Formulates practice policies and procedures, and ensures that all modifications are communicated effectively to affected staff members. Identifies areas for improvements to quality, the patient experience, and process efficiency, and develops actionable initiatives to attain these goals. Manages financial planning. Assists with practice marketing efforts. Collaborates with physicians and practice leaders to supervise physician on-boarding. Promotes exceptional customer service standards at the medical group practice. Makes certain that patients are assisted in accordance with their needs and treated with consideration by all staff members. Ensures that all applicable regulatory compliance standards and laws are consistently upheld (e.g., HIPAA, OSHA, Medicare, CLIA, etc.) Maintain contract for billing system (Medical Manager data sets.) Maintain internal/external client billing contracts. Responsible for report related collections for internal/external client billing contracts. Performs other duties as necessary. MINIMUM QUALIFICATIONS: QUALIFICATIONS-EDUCATION: BS or BA degree in business administration, business or finance management or related field. QUALIFICATIONS-EXPERIENCE: Ten years’ experience in physician or medical practice billing with a minimum of seven years supervisory experience. Knowledge of physician billing and electronic medical records systems such as eClinicalWorks, Epic, Siemens, and Cerner. Advanced knowledge of ICD/CPT coding and medical terminology. Certification as a professional coder (CPC) strongly preferred. The advanced professional’s level of knowledge of software applications/services, databases and database management, and the like, used in medical accounts receivables management, including the application of payer contract provisions and advanced workflow and collections systems. The advanced professional 's level of knowledge of software applications/services, databases and database management, and the like, used in medical accounts receivables management, including the application of payer contract provisions and advanced workflow and collections systems. SUPERVISION: Management responsibility for up to 50 FTEs. Pay Range: $134,035.20-$221,187.20 EEO Statement: Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment. Location: Corporate Headquarters - 15 LaSalle Square Providence, Rhode Island 02903 Work Type: 8:00-4:30 Work Shift: Day Daily Hours: 8 hours Driving Required: No As Rhode Island's largest health system and private employer, Brown University Health is the state's premier provider of health services and includes the only Level I Trauma Center for southeastern New England. Today, more than 20,000 people work at Brown University Health and bring their unique skills, experiences, and compassion to their jobs every day. Formed in 1994, Brown University Health is a not-for-profit health system based in Providence, RI comprising three teaching hospitals of The Warren Alpert Medical School of Brown University: Rhode Island Hospital and its Hasbro Children's; The Miriam Hospital; and Bradley Hospital, the nation’s first psychiatric hospital for children; Newport Hospital, Saint Anne's Hospital and Morton Hospital, community hospitals offering a broad range of health services; Gateway Healthcare, the state’s largest provider of community behavioral health care; and Brown Health Medical Group, the largest multi-specialty practice in Rhode Island. Brown University Health is an equal opportunity employer that values diversity of cultural background, race, gender, age, religion, identity, ability, and perspectives - we are actively committed to a diverse workforce that represents the patients and community that we serve. We are invested in creating a respectful, inclusive, and equitable environment that supports the holistic well-being of our employees and their families. Join us and help build a healthier future for our patients - and for yourself. Company Location Belonging and Engagement Nursing Our Mission

Requirements

BS or BA degree in business administration, business or finance management or related field.
Ten years’ experience in physician or medical practice billing with a minimum of seven years supervisory experience.
Knowledge of physician billing and electronic medical records systems such as eClinicalWorks, Epic, Siemens, and Cerner.
Advanced knowledge of ICD/CPT coding and medical terminology.
The advanced professional’s level of knowledge of software applications/services, databases and database management, and the like, used in medical accounts receivables management, including the application of payer contract provisions and advanced workflow and collections systems.
Management responsibility for up to 50 FTEs.

Nice To Haves

Certification as a professional coder (CPC) strongly preferred.

Responsibilities

Implements and maintains billing procedures for all services related to Lifespan’s medical practices.
Supports the integration of new physicians/practices and accounts receivable systems to maximize first pass resolution and net collection rates, and improve days outstanding.
Ensures the implementation of the overall practice patient accounting functions to include charge entry, billing, follow up, cash application, and self-pay/bad debt functions.
Develops and establishes methods to monitor and evaluate effectiveness of contracted patient account - billing services and systems, identifying opportunities for standardization of billing operations and practices.
Responsible for ensuring the medical data is secure, accessible, and accurate for billing purposes.
Ensures all proper disease classification and procedure (ICD/CPT) coding is used in the billing functions.
Focuses practices on issues that will positively impact financial performance.
Assesses impact of new regulations or newly established or modified codes from a coding, compliance and reimbursement perspective.
Develops expertise for assigned practices.
Analyzes receivables in order to solve technical and managerial problems relative to complex plans, systems, and programs.
Tracks, trends, and analyzes receivables and associated cash to quickly enable the detection of variations adversely affecting cash flow.
Implements and maintains robust reporting systems to ensure that practice management receives and understand productivity quality measures.
Responsible for the accurate and timely cash application, including unprocessed cash, obtaining additional information from payers whenever needed.
Maintains technical and industry awareness of new product knowledge of cash management, collection systems and trends.
Responsible for responding to internal and external audits for the medical practices and the Lifespan Physician Group.
Participates in audit process, reviews and direct the implementation of audit follow-up recommendations as required.
Ensures that self-pay and bad debt policies are administered consistently and in accordance with established standards for same.
Responsible for timely processing of all address corrections to self-pay mail and itemized bill requests.
Responsible for providing and communicating expedient resolutions to any patient complaints.
Responsible for all department budgets and the implementation of approved systems and processes in support of the delivery of quality patient care, efficient and effective medical practice operations and successful financial performance.
Recruits, hires, and trains qualified staff members.
Manages and supports administrative and clinical staff, and provides regular feedback about individual and team performance.
Communicates regularly with staff members to foster an environment of teamwork and cooperation.
Formulates practice policies and procedures, and ensures that all modifications are communicated effectively to affected staff members.
Identifies areas for improvements to quality, the patient experience, and process efficiency, and develops actionable initiatives to attain these goals.
Manages financial planning.
Assists with practice marketing efforts.
Collaborates with physicians and practice leaders to supervise physician on-boarding.
Promotes exceptional customer service standards at the medical group practice.
Makes certain that patients are assisted in accordance with their needs and treated with consideration by all staff members.
Ensures that all applicable regulatory compliance standards and laws are consistently upheld (e.g., HIPAA, OSHA, Medicare, CLIA, etc.)
Maintain contract for billing system (Medical Manager data sets.)
Maintain internal/external client billing contracts.
Responsible for report related collections for internal/external client billing contracts.
Performs other duties as necessary.