Job Details

Description

We are looking for a Senior Director, Revenue Cycle to join our collaborative team at Memorial Health! 

What You'll Do:

Revenue Cycle Management:

• Serves as expert consultant to Sr. Leadership in all matters relating to the Revenue Cycle
• Drives Revenue Cycle operational performance and key financial metrics
• Leads strategic planning for revenue/reimbursement performance goals
• Ensures maximization of cash flow while supporting strategic initiatives
• Provides outstanding service to external and internal customers
• Identifies opportunities to improve financial performance
• Formulates and makes recommendations on policies and practices relating to revenue cycle improvements and implements best practices
• Facilitates compliance with federal and state regulatory requirements
• Maintains fiscal responsibility for revenue cycle activities, while ensuring appropriate resources and technologies are identified and utilized
• Develops internal control methodologies and ensures adherence throughout the Revenue Cycle
• Researches, interprets and makes recommendations on prospective contracting arrangements
• As Chair of Revenue Cycle Team, develop strategic plan for Revenue Cycle team and ensures that goals and objectives of the team are properly defined and clearly established.

Strategic direction and leadership for the following departments/functions: Patient Financial Services, Registration, Central Scheduling, Charge Description Master (CDM) Coordinator, Hospital Contract Modeling, and PBX system functions and systems.

• Ensures accuracy and quality of demographic and financial information at registration
• Maximizes reimbursement through financial counseling for the uninsured and underinsured and accurate and timely billing and collection
• Facilitates timely and complete resolution of all customer questions and concerns
• Monitor, assess, and mitigate key risks related to billing and charge capture requirements
• Establish/implement department goals in support of the Hospital’s strategic plan
• Establish and monitor annual Key Results Measures (KRM)
• Establish departmental policies, procedures and workflow and schedule review per Hospital policy
• Establish staffing productivity measures and ensure employee accountability
• Develop expense and capital budgets; managing and monitoring expenses as appropriate
• Provide mentoring, training and development for management team and staff
• Participate in and oversee staffing interviews, employee selection, performance evaluations, and disciplinary actions
• Oversight of payer contract modeling for use in contract negotiations
• Monitor payer reimbursement through system variance reports
• Oversight of annual pricing study, new service line research and establishing system order codes and charge codes for use in the Health Information System (HIS).

Payer Relations and Contract Administration:

• Serves as liaison for all payer-related matters
• Develops and fosters strong payer relations with government oversight agencies and contracted health plans
• Maintains a comprehensive knowledge and understanding of all Hospital payer contracts, terms and reimbursement
• Maintains a comprehensive knowledge of medical policy as it applies to each payer
• Engages in problem-solving and resolution with contracted payers to ensure accurate and timely reimbursement
• Oversee all on-site payer credit balance audits
• Facilitates resolution of physician billing issues arising from affiliation with the Hospital

Analysis and Reporting:

• Compiles data and provides key performance indicators to Sr. Leadership
• Coordinate financial and utilization analysis to develop recommendations for payer contracting strategy
• Compile and prepare data, reports and analyses for various Hospital departments and directors. Prepare and send Credit Balance report to CMS quarterly. Oversight and assist with data collection for Hospital Care Assurance Program (HCAP), Hospital Charity Care (CC), Medicare and Medicaid Cost Reports, Bad Debt report and annual payer Credit Balance Reviews
• Analyze reports and outcomes as they pertain to revenue cycle management; to include but not limited to monitoring of accounts receivable (A/R), claim denials and appeals, late charges, key performance indicators, ICD-10 financial monitoring, scheduling/call statistics, authorizations and registration quality. Report out to senior leader as appropriate
• Actively participates in management and other Hospital committee meetings. Participate on Disaster Team, Work-In-Progress (WIP) Team, Technology Team and Compliance Committee

Business Systems Oversight:

• Provide leadership in the continued development and implementation of software systems and applications to facilitate more effective operations, reporting and decision making
• Ensure all systems dictionary files, data elements, interface and mappings are maintained

Management of Extended Business Office (EBO) and collection agency processes:

• Ensure adherence to regulatory and compliance
• File Transfer set-up and secure to ensure adherence to Health Insurance Portability and Accountability Act (HIPAA) requirements

Other Responsibilities:

• Responds to emergencies outside normal work hours.            
• Exhibits behaviors reflective of Memorial’s core values: Compassion, Accountability, Respect, Excellence, and Service
• Demonstrates regular and predictable attendance
• Attends all mandatory education and in-services (i.e., team training, safety, infection control, etc.); completes mandatory health requirements.
• Employee performs within the prescribed limits of the hospital’s and department’s Ethics and Compliance program and is responsible to detect, observe and report compliance variances to their immediate supervisor, or upward through the chain of command, the Compliance Officer, or the hospital hotline

• Performs other duties as required or assigned.

Requirements

Bachelor’s degree (Master’s preferred) with an emphasis on finance, accounting or healthcare administration. 8 years of progressive revenue cycle leadership experience in a Health System or multi-location hospital environment. 8 years of experience dealing with rules/regulations of Medicare/Medicaid and other government payers as well as commercial insurers.

Strong Excel, Access and presentation software skills; critical thinking, analytical and mathematical skills, medical insurance terminology, billing and collections, billing systems, detail oriented with strong organizational skills

Shift
1st

Hours
80 per pay (Every two weeks)

Benefits
• Medical Insurance
• Dental Insurance
• Vision Insurance
• Life Insurance
• Flexible Spending Account

Time Off
• Vacation
• Sick Leave
• 11 Paid Holidays
• Personal Day

Retirement
• Ohio Public Employee Retirement System
• Deferred Compensation

Other
• Tuition Reimbursement
• Kidzlink Daycare Center
• Employee Recognition
• Free Parking
• Wellness Center
• Competitive Salaries
• Community/Family Atmosphere

Location

Approx. 25 minutes away from Dublin, OH
Approx. 30 minutes away from Hillard, OH
Approx. 30 minutes away from Delaware, OH
Approx. 30 minutes away from Powell, OH

We look forward to seeing your application!

It is our commitment to inclusivity and diversity and our ongoing determination to provide a welcoming and inclusive environment for all staff and guests of the Hospital, regardless of age, color, disability, gender, gender expression or gender identity, genetic information, national origin, race, religion, sexual orientation, or veteran status.  For any questions or needed accommodations, please contact Memorial Health Human Resources at 937.578.2701.

Behaviors

Motivations

Education

Experience

Licenses & Certifications