DIR - REVENUE CYCLE

UHS•Riverside, CA

About The Position

SUMMARY: Directly supervises employees in the Revenue Cycle/Business Office. Carries out supervisory responsibilities in accordance with the organization’s policies and applicable laws. Responsibilities include interviewing, hiring, training employees, planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Hours: 8:30am-5:30pm

Requirements

Bachelor’s degree (BA/BS) in Health Care or related work experience required.
Minimum (5) five years’ experience in a clinical or HMO/Prepaid Business Office environment with (3) three years of management experience required.
Certification on medical procedural coding or equivalent work experience.

Nice To Haves

Master’s Degree preferred.

Responsibilities

Develops strategic plans and programs for Revenue Cycle (RC) team, oversees, monitors, and reports on annual and monthly performance targets for RC compared to industry benchmarks for all enterprise locations.
Utilizing available business intelligence, analyzes RC trends and leverages information to develop solutions to optimize RC performance.
Interacts with senior leadership at all locations with respect to RC performance including regular reporting of RC results.
Assures monitoring of all revenue cycle services performed by outside vendors, such as statement processing, EDI vendors, Bad Debt agency performance.
Analyzes enterprise-wide revenue cycle trends and provides insight into strategic implications.
Ensures that all revenue cycle policies and procedures are adhered to and updated as necessary.
Reviews and monitors all payer contract performance and compliance and reimbursement requirements to ensure each payer is adhering to contract terms and conditions.
Coordinates with the provider credentialing department to ensure data is accurate for new payers and new locations and to resolve credentialing data impacting claim processing.
Participates in the development of the annual revenue operating budgets for all locations.
Oversees and ensures that all HIPAA and PHI policies are being followed within the RC team.
Coordinates/ interacts with many other departments in the enterprise in the successful execution of RC activities including: Patient Scheduling, Orders, Prior Authorization, Registration, Clinic Operations Management and IT Support departments.
Interview, hire, initiate corrective action, termination decisions; monitor employee performance and conduct evaluations.
Orient, train coach, and re-orient staff.
Participate in the development and implementation of business development and marketing plans.
Conduct and participate in meetings as a representative of the Business Office.
Keeps CFO informed of issues and concerns affecting the organization.