Executive Director, Revenue Cycle

Illinois Bone and Joint Institute LLC•Park Ridge, IL

10m•Onsite

About The Position

Founded in 1991, IBJI is the largest orthopedic group practice in Illinois, with over 150 physicians across more than 100 locations in northern Illinois and northwest Indiana. IBJI offers comprehensive care including MRI imaging, pain management, surgical and non-surgical treatments, rheumatology, physical and occupational therapy, wellness, and sports training, along with Ortho Access walk-in clinics for immediate orthopedic injuries. The organization emphasizes collaborative care for better patient outcomes and cost efficiency compared to larger healthcare systems. The Executive Director is responsible for developing and directing revenue cycle management operations for Illinois Bone & Joint Institute. This includes creating strategies to optimize operations and revenue efficiency, establishing targets, policies, and internal controls to improve service revenue capture and collection, and ensuring compliance with regulatory requirements. The role also involves coordinating with various stakeholders across the organization to drive optimal financial performance.

Requirements

Bachelor degree in related field or equivalent experience.
Minimum of ten (10) years of medical billing experience
Minimum of five years in a supervisory role
Knowledge of professional fee billing, reimbursement and third party payer regulations and medical terminology is required
Knowledge of all regulatory reimbursement and insurance related requirements
Strong working knowledge of medical terminology, CPT, HCPCS, ICD9 and ICD10
A systematic approach to problem solving for all types of issues
Strong skills in fostering working relationships
Detail oriented; organized; sets priorities; meets deadlines
Advanced skills in computer programs, particularly Microsoft Excel
Effective and clear oral and written communication skills with individuals and groups

Nice To Haves

Certified coder preferred

Responsibilities

Provides executive leadership, oversight and direction to the full revenue cycle function: reimbursement, coding & compliance
Champions revenue cycle improvements throughout the organization include working with appropriate individuals to aid the resolution of identified revenue cycle issues.
Develops and nurtures key relationships across IBJI. This role works closely with Compliance, Epic, physician leadership, practice administrators and executive team members to ensure alignment around key principles. Training, education, and proactive communication will be paramount.
Builds a culture that balances the importance of compliance with active communication, education, and partnership.
Reviews, designs, and implements processes to ensure operational efficiency of the revenue cycle function.
Implements and monitors collection procedures, minimizing contractual and bad debt write-offs, and maximizing cash collections
Tracks numerous metrics related to the revenue cycle including coding error rates, denials, accounts receivable to develop sound revenue cycle analysis and reporting
Monitors analytical data of revenue cycle to be proactive in operations.
Performs ongoing trend analysis of third-party payer rejects and denials. Develops training programs for registration, billing, and coding staff to eliminate/reduce rejects/denials
Monitors and ensures adherence to payer guidelines and regulatory compliance.
Manages payer and specialty contracts to ensure contract compliance
Performs ongoing trend analysis on third party payer payments to ensure reimbursement is in accordance with allowable amounts stated in agreements and contracts. Works with appropriate individuals to resolve discrepancies
Develop policies/procedures to support the functional infrastructure
Provides financial support and analysis to physician practices through communication and education.
Communicates actively with administrators, providers, and other individuals to proactively review specific coding and collection issues and mitigate elevated concerns.
Participate actively in staff development and assessments to support industry best practice