Revenue Cycle Director

Description:

Director of Revenue Cycle

Little Rock, AR

Description Arkansas Urology




Job Code:

Exempt: Yes

Department: Business and Billing Operations

Reports To: Chief Financial Officer

Location: Clinic and ASC

Date Prepared:

Date Revised:

GENERAL DESCRIPTION OF POSITION

The Director of Revenue Cycle is responsible for oversight of the Revenue Cycle Management activities to include billing, coding, estimates, and prior authorization departments, including policies, objectives, and initiatives within Arkansas Urology (AU) and Centerview Surgery Center (CSC). This Director is also responsible for oversight of Scheduling operations of Centerview Surgery Center.

ESSENTIAL DUTIES AND RESPONSIBILITIES

To perform this job successfully, an individual must be able to perform the following satisfactorily; other duties may be assigned.

1. To develop and implement policies and procedures for all stages of the revenue cycle to ensure maximum efficiency and compliance.

2. Monitor key performance indicators (KPIs) and generate reports to track the effectiveness of revenue cycle activities. Determine appropriate and effective performance metrics and staff requirements for the department to run with efficiency, accuracy and outstanding customer service.

3. Utilize electronic health records (EHR) and revenue cycle management software to streamline operations and data analysis.

4. Develops all Revenue Cycle procedures and policies for AU and CSC with the approval of executive leadership.

5. Stay abreast of changes in healthcare regulations, payer policies, and industry trends to adapt strategies accordingly.

6. Coordinate with other departments, such as compliance and finance, to ensure the integrity of financial reporting and adherence to legal and regulatory standards.

7. Resolve complex patient, physician and clinician issues related to charging, coding, documentation, and CSC Scheduling matters as necessary.

8. Promotes a team-oriented environment that fosters effective collaboration within and outside of the group.

9. Develops and updates staff training program. This includes educating clinical staff to increase the effectiveness and efficiency of clinical documentation to ensure the highest possible reimbursement for the services rendered.

10. Maintains confidentiality in compliance with HIPAA regulations and ensures that department remains compliant with all relevant regulations.

11. Play a significant role in long-term planning, including an initiative geared toward operational excellence.

12. Works with the CSC Administrator to manage all aspects of CSC software

13. Develop and maintain documentation audit schedule, completing at least 2 audits yearly.

14. Perform any other related duties as required or assigned.

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty mentioned satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

EDUCATION AND EXPERIENCE

Mental alertness and adaptability to office and field area work routines. Equivalent to four years high school or GED, with particular emphasis during high school in office skills, shop skills, or others, plus 5 years related experience and/or training. Or equivalent combination of education and experience.

COMMUNICATION SKILLS

Ability to read, analyze, and understand common scientific and technical journals, financial reports, and legal documents; Ability to respond to complex or difficult inquiries or complaints from customers, regulatory agencies, or members of the business community. Ability to write speeches and articles for publication that conform to prescribed style and format; Ability to effectively present information to top management, public groups, and/or boards of directors.

MATHEMATICAL SKILLS

Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts such as fractions, ratios, and proportions to practical situations.

CRITICAL THINKING SKILLS

Ability to define problems collects data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.

REQUIRED CERTIFICATES, LICENSES, REGISTRATIONS

Not indicated.

PREFERRED CERTIFICATES, LICENSES, REGISTRATIONS


SOFTWARE SKILLS REQUIRED

Intermediate: Database, Spreadsheet

Basic: Alphanumeric Data Entry, Contact Management, Word Processing/Typing

INITIATIVE AND INGENUITY

SUPERVISION RECEIVED

Under administrative direction, setting up own standard of performance. Virtually self-supervising. Reports to senior management of the organization.

PLANNING

Considerable responsibility with regard to general assignments in planning time, method, manner, and/or sequence of performance of own work, in addition, the organization and delegation of work operations for a group of employees engaged in widely diversified activities.

DECISION MAKING

Performs work operations which permit frequent opportunity for decision-making of major importance which would have considerable effect on the final attainment of multiple major activities and the organization's projects of a large organization component and organization's clientele.

MENTAL DEMAND

Comprehensive and very intense mental demand. Comprehensive and continual involvement with multiple divisions, departments and/or organizations. Strategic and operational management functions which relate to both the short-term and long-term time periods.

ANALYTICAL ABILITY / PROBLEM SOLVING

General oversight. Activities covered by general organizational philosophy and objectives. Solving problems in novel, non-recurring or swiftly changing situations in which the approach is not fully defined. Guidance by top executive officer or business owner.

SUPERVISORY RESPONSIBILITIES

Supervises and manages multiple departments whose employees who are engaged in diversified activities related to the business and billing operations.

Oversees the following departments: Insurance Follow Up, Payment Posters and Coding.

Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring and training employees; planning, assigning and directing work; appraising performance, rewarding and disciplining employees; addressing complaints and resolving problems.

RESPONSIBILITY FOR FUNDS, PROPERTY and EQUIPMENT

Regularly responsible for funds, building pre.