Director of Revenue Cycle

Central Ozarks Medical Center•Richland, MO

13d

About The Position

Revenue Cycle: Manage all insurance payer and Medicare/Medicaid contracts File Medicare Credit Balance Reports Quarterly Review Charge Fee Schedules periodically to ensure appropriate rates are billed to payers Analyze systems and procedures to recommend changes and improve workflow and efficiency in billing department. Produce monthly statistical reports for management on billing-related tasks; maintains statistics for quarterly and annual reporting. Develops standardized procedures for all areas of responsibility Develops and supplies subject matter and expertise coding guidelines, medical terminology, and reimbursement schemes and payor-specific guidelines. Share pertinent information and advise senior management on positive and negative changes that can impact COMC clinics. Hiring, training, and annual evaluation of department staff Manages Billing Staff, conducts regular meetings to discuss projects, make decisions, and share pertinent information with team. Other duties as assigned Performance Improvement Management- Collaborates with the Chief Quality and Risk Officer to: Assists in tracking clinical quality and productivity aspects of the organization’s services. Work with CQRO in developing methods of collecting and reporting performance measures. Assists CQRO in analyzing, evaluating, and presenting information such as population trends, clinical quality, and patient satisfaction to lead the clinic in performance improvement initiatives. Assists CQRO to establish and revise clinical, quality, risk, and patient-related policies. Assists the CQRO with completion of Quality Improvement reports, as well as reports required by Grants, State performance measures, and Federal UDS report performance measures. Participates in Quality Improvement meetings. Other duties as assigned

Requirements

Bachelor’s degree in health care administration, business, or related field.
Experience in health care management.
Knowledge of CPT and ICD10 codes and medical experience required.
8-10 years Supervisory experience required.
Experience in financial project management, financial data analysis, and reporting.
Knowledge of state and federal laws and requirements relating to healthcare management.
Ability to read, analyze, and interpret financial reports.
Ability to respond to common inquiries or complaints from customers, vendors, and regulatory agencies.
Ability to effectively present information to top management.
High level of communication proficiency.
Ability to work with accounting concepts such as income and expense statements, budgets, and controls on cash such as into and out of COMC for deposit to the bank.
Understanding of financial data analysis and reporting.
Financial management.
Ability to define problems, collect data, establish facts, and draw valid conclusions.
In-depth knowledge and full scope of information processing, telecommunications, and related technologies.
Time management, ability to set priorities and meet deadlines; strong interpersonal communication and leadership skills.
Ability to operate office equipment and computer skills required.
Accounting, Corporate Finance, Reporting Skills, Analytical skills, Attention to Detail, Deadline-Oriented, Reporting Research Results, SFAS Rules, Organization, Confidentiality, Time Management, Data Entry Management.
Problem solving.
Decision making.
Knowledge and compliance with HIPAA and 340B requirements is required.
Confidentiality of patient information is mandatory.
Employee must have valid Missouri driver’s license and availability of a motor vehicle.

Nice To Haves

Some corporate purchasing experience preferred.
8-10 years of professional experience in a healthcare setting preferred.
Experience with accounting in a healthcare organization preferred.
Experience with DRVS and Health Information Exchange implementation and maintenance preferred.
EHR specialist; experience with e-Clinical Works highly preferred.

Responsibilities

Manage all insurance payer and Medicare/Medicaid contracts
File Medicare Credit Balance Reports Quarterly
Review Charge Fee Schedules periodically to ensure appropriate rates are billed to payers
Analyze systems and procedures to recommend changes and improve workflow and efficiency in billing department.
Produce monthly statistical reports for management on billing-related tasks; maintains statistics for quarterly and annual reporting.
Develops standardized procedures for all areas of responsibility
Develops and supplies subject matter and expertise coding guidelines, medical terminology, and reimbursement schemes and payor-specific guidelines.
Share pertinent information and advise senior management on positive and negative changes that can impact COMC clinics.
Hiring, training, and annual evaluation of department staff
Manages Billing Staff, conducts regular meetings to discuss projects, make decisions, and share pertinent information with team.
Assists in tracking clinical quality and productivity aspects of the organization’s services.
Work with CQRO in developing methods of collecting and reporting performance measures.
Assists CQRO in analyzing, evaluating, and presenting information such as population trends, clinical quality, and patient satisfaction to lead the clinic in performance improvement initiatives.
Assists CQRO to establish and revise clinical, quality, risk, and patient-related policies.
Assists the CQRO with completion of Quality Improvement reports, as well as reports required by Grants, State performance measures, and Federal UDS report performance measures.
Participates in Quality Improvement meetings.