10349 Revenue Cycle - Revenue Recovery Denials PreventionFull timeYes40

M-F standard business hours

Major Responsibilities:

• Oversees the billing and claims processing for Illinois or Wisconsin for hospital or physician billing operations to ensure timely, accurate and compliant claims processing. Oversees the optimization of net revenue related to reimbursement from third party payers.
• Develops and utilizes key Performance Indicators (KPI's) to analyze processes in order to streamline workflow, design operations and improve quality and service and revenue cycle performance in conjunction with the other billing directors. Works with management and staff to establish and achieve performance objectives.
• Compiles and utilizes statistical information to be used for current operations and future planning. Analyzes leading indicators and operating metrics; develops plans in response to data; establishes goals, standards and target time frames for initiative implementation and completion.
• Directs and manages the activities of leaders to set the standard for prompt resolution of payer issues resulting in payment delays. Ensures performance metrics are within established thresholds while maintaining the highest level of patient and other customer satisfaction.
• Works collaboratively with facility directors, site leaders, other billing directors and Patient Relations teams to ensure service guidelines are met.
• Reviews departmental productivity and quality levels and allocates resources based on operational trends and performance to achieve overall revenue cycle goals and objectives.
• Oversees the design and utilization of work flow tools to achieve and exceed established department goals, objectives and best practice results.
• Develop department productivity and quality standards to improve patient satisfaction within span of control. Benchmark to industry standards.
• Performs human resources responsibilities for staff which include interviewing and selection of new employees, promotions, staff development, performance evaluations, compensation changes, resolution of employee concerns, corrective actions, terminations, and overall employee morale.
• Develops and recommends operating and capital budgets and controls expenditures within approved budget objectives.
• Responsible for understanding and adhering to the organization's Code of Ethical Conduct and for ensuring that personal actions, and the actions of employees supervised, comply with the policies, regulations and laws applicable to the organization's business.

Licensure, Registration, and/or Certification Required:

• None Required.

Education Required:

• Bachelor's Degree in Business or related field, or
• Bachelor's Degree in Finance or related field.

Experience Required:

• Typically requires 7 years of experience in accounting and finance. Includes 3 years of management experience in managing reimbursement and receivables management.

Knowledge, Skills & Abilities Required:

• Demonstrates high performance of management skills including ability to work well with others, team building skills, organizational, communication and presentation skills.
• Strong background and knowledge in both hospital and physician revenue cycle operations/principles.
• Demonstrated skill in critical thinking, diplomacy and relationship building.
• Proven ability in process redesign skills.
• Ability to effectively manage and coordinate many different personnel responsible for billing and collection activities.
• Experience in executing change and results based upon data analytics and directed goal sets of the leader of billing operations.
• Demonstrated self-directed, results oriented and creative approach to problem solving.
• Ability to work in high volume, high stress environment.
• Previous experience with system conversion and office re-structure.
• Ability to manage multiple sites and travel between sites.
• Demonstrated interest in employee development, ability in interpersonal communications and sensitivity to team member needs.

Physical Requirements and Working Conditions:

• Operates all equipment necessary to perform the job.
• Exposed to normal office environment.
• Occasionally lifts up to 20 lbs. when lifting laptop personal computer.
• Sits the majority of the workday.
• Exposed to road/weather conditions as required to drive to other sites.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.