Revenue Cycle Director
Work Hours: M-F
Directs the day to day operations that contribute to the capture, management, and collection of revenue for hospital and physician billing services. Enhances and maintains revenue cycle management functions including, but not limited to, registration, medical records, chart audit, coding, billing, follow-up, cash posting, utilization review, compliance, and customer service. Ensures timely activity on accounts receivable to maximize collections in compliance with all state and federal regulations. Establishes objectives and standards in order to measure effectiveness and quality of work and continuously improves processes, services, and systems to support organizational goals.
Education: Bachelor's degree preferred.
Experience: Five years successful revenue cycle managerial experience.
Licenses/Certification: AAHAM Certified Revenue Cycle Executive or Certified Healthcare Financial Professional preferred.
· Observes professional ethics in maintaining confidential information concerning the personal, financial, medical, or employment status of a patient of GVH and their families.
· Directs the registration, medical records, chart audit, coding, billing, follow-up, cash posting, utilization review, compliance, and customer service activities of the Admissions, Health Information Management, Patient Financial Services, and Utilization Review Departments.
· Develops processes and systems using a team approach to improve financial performance and cash flow and coordinates activities to integrate optimally with hospital operations.
· Works with senior leadership to establish financial goals and objectives for the organization and communicates them to the revenue cycle supervisors and staff.
· Manages employees by selecting talented people, trains, and evaluates them and ensures they are compliant with hospital policies and procedures.
· Adheres to the standards and policies of the hospital's compliance program, including the duty to comply with applicable laws and regulations, and reports any suspected unethical, fraudulent, or unlawful acts or practices.
· Identifies potential areas of compliance vulnerability and risk and works with senior leadership to develop corrective action plans for resolution of problematic areas.
· Stays current on all regulations and standards to ensure compliance with orders or directives issued by governmental/regulatory agencies and disseminates appropriate information to appropriate leadership and staff.
· Maintains and updates the hospital's Charge Description Master in CPSI software for all departments and is a resource to leadership for research on charge issues.
· Works closely with business partners providing services to GVH and monitors their activities, including early out, bad debt, coding, billing, transcription, payor enrollment, managed care contracting, and statement vendors.
· Acts as the Privacy Officer in the management of the hospital's privacy program.
· Ensures that patients receive prompt and accurate answers to their inquiries regarding any revenue cycle activity.
· Provides for the development and growth of revenue cycle supervisors and staff by providing educational and training opportunities.
· Demonstrates commitment to professional growth through participation in professional organizations, workshops, educational programs, review of literature, in-services, and staff meetings to meet the changing needs of patients and staff.
· Recommends software, space, staffing requirements, and other resources to provide needed services.
· Ensures cash controls and adjustment oversight are in place and monitored.
· Ensures that federal and state quarterly reporting requirements, including the MAC, CAAS, CICP, and QI are met.
· Patient satisfaction scores and feedback are used to provide focus in order to generate action plans that address revenue cycle functions so that Gunnison Valley Hospital will be perceived as a patient friendly organization.
· Establishes accuracy standards and uses benchmarks to measure the efficiency and success of revenue cycle activities.
· Prepares annual budget for the Admissions, HIM, PFS, and UR Departments.
· Writes policies and procedures to enhance revenue cycle activities.
· Prepares and distributes statistical information on the activities of the Admissions, HIM, PFS, and UR Departments.
· Participates in audit activities, ensuring compliance and accuracy, by preparing reports and acting as a resource for the auditors.
· Demonstrates a strong understanding of and support of the hospital's quality improvement activities.
· Maintains a positive working relationship with Administration, Directors, physicians and their office staff, hospital staff, and vendors to ensure goals are optimized and that good working relationships are cultivated and retained.
· Demonstrates a positive demeanor, good verbal and written communication skills, and is professional in both appearance and approach.
· Participates in drills and emergency response training and may be called in for GVH disaster response.
· Other duties as assigned.