Director, Revenue Analysis

Community Health Systems Professional Services Corporation•Fort Wayne, IN

About The Position

The Director, Revenue Cycle provides overall leadership, management and direction of the revenue cycle function. Responsibilities include but are not limited to DAR/Pulse documentation, Alert/APC edits, billing guidelines, uniform CDM, support system requests, external vendor systems, create and define strategic objectives and implementing process redesign, policies and measurement tools. Essential Functions Defines and establishes strategic direction and priorities for the revenue cycle operations. Directs the management and operations of Revenue Cycle/Collections services to provide high quality cost-effective customer service. Works with leadership to implement best practice workflows and ensures adherence to policies and procedures as related to revenue cycle operations. Oversees all revenue cycle processes and ensures key metrics are met by analyzing data and optimizing performance. Responsible for ensuring all escalations related to daily operations revenue cycle are handled appropriately; notifying leadership as appropriate. Effectively leads, coaches, and counsels supervisors, managers, and other revenue cycle team members as necessary. Reviews action plans and educates supervisors, managers, and clinic operations teams (staff, providers, leadership) on proper follow up techniques. Reviews daily, weekly, and monthly clinic operations indicators and takes appropriate steps with leadership to address and improve. Audits transactions posted to patient accounts to ensure accuracy; educates where appropriate. Audits staff investigation and resolution of billing concerns; educates where appropriate. Audits and reconciles cash with Bank and General Ledger to insure proper controls and complete accountability of funds received. Participates in integration efforts for new practice management systems/vendors including on site training and installation of policy and procedures for revenue cycle or other related areas of responsibility (i.e. Ingenious Med Utilization). Responsible for routine on site review of daily practice operations; ability to assess and complete gap analysis of all work streams that intersect with revenue cycle working with corporate resources, clinic operations including leadership; and other area leaders to ensure all gaps are closed. Responsible to review monthly KPI’s and communicate problematic trends for intervention and resolution with corporate including leadership as appropriate. Responsible for working knowledge of payer fee-for-service contracts and value-based care contracts. Possess ability to work in a matrix environment where multiple or competing customer demands are likely. Performs other duties as assigned. Maintains regular and reliable attendance. Complies with all policies and standards. Leadership Responsibilities Supervision and Staff Management Provides leadership, mentorship and professional development opportunities for departmental staff. Schedules employees to ensure effective use of resources. Consults with leadership on any potential staffing issues. Conducts performance evaluations, sets goals and provides feedback to staff on their performance and development. Strategic Planning and Financial Oversight Collaborates with hospital leadership to set the strategic direction for the department, including budgeting, resource allocation and long-term planning. Monitors expenditures, ensuring cost-effective delivery of services. Evaluates and implements new technologies to enhance operational efficiency. Develops and implements departmental policies and procedures and protocols to optimize quality and overall efficiencies. Quality Assurance and Regulatory Compliance Ensures compliance with all relevant regulatory bodies. May oversee the accreditation process with relevant agencies ensuring that services meet or exceed industry standards. Participates in audits, inspections and accreditation processes as applicable. Follows established quality control practices to ensure accuracy, consistency and safety. Collaboration and Communication Works closely with leadership teams to coordinate and improve service delivery. Stays up-to-date with industry advancements, new technologies, and regulatory changes. Staff Responsibilities May work in a staff role, when required. Ensures that duties and responsibilities are fulfilled while meeting all competencies established for that job.

Requirements

Bachelor's Degree in relevant field required or
Seven (7) plus years of direct experience in lieu of a Bachelor's degree required
3-5 years of experience in closely related field with Bachelor's degree required
Strong leadership, organizational, and communication skills.
Ability to collaborate with interdisciplinary teams and manage cross-functional relationships.
Foster a positive work environment that promotes teamwork, professionalism, and continuous improvement.
Communicate effectively with leadership, team members, and stakeholders.
Ability to work effectively with others, delegate responsibilities, and independently manage tasks while meeting established deadlines.
Problem-solving and critical thinking skills.
In depth knowledge of industry best practices and regulatory compliance (if applicable).
Strong organizational and time management skills.
Proficiency with Google and Microsoft platforms, healthcare software systems, and data analysis tools.

Nice To Haves

Master's Degree preferred
3-5 years of previous leadership experience preferred
CPB Certified Biller through AAPC preferred
CMIS through PMI preferred
CMRS through ABA preferred

Responsibilities

Defines and establishes strategic direction and priorities for the revenue cycle operations.
Directs the management and operations of Revenue Cycle/Collections services to provide high quality cost-effective customer service.
Works with leadership to implement best practice workflows and ensures adherence to policies and procedures as related to revenue cycle operations.
Oversees all revenue cycle processes and ensures key metrics are met by analyzing data and optimizing performance.
Responsible for ensuring all escalations related to daily operations revenue cycle are handled appropriately; notifying leadership as appropriate.
Effectively leads, coaches, and counsels supervisors, managers, and other revenue cycle team members as necessary.
Reviews action plans and educates supervisors, managers, and clinic operations teams (staff, providers, leadership) on proper follow up techniques.
Reviews daily, weekly, and monthly clinic operations indicators and takes appropriate steps with leadership to address and improve.
Audits transactions posted to patient accounts to ensure accuracy; educates where appropriate.
Audits staff investigation and resolution of billing concerns; educates where appropriate.
Audits and reconciles cash with Bank and General Ledger to insure proper controls and complete accountability of funds received.
Participates in integration efforts for new practice management systems/vendors including on site training and installation of policy and procedures for revenue cycle or other related areas of responsibility (i.e. Ingenious Med Utilization).
Responsible for routine on site review of daily practice operations; ability to assess and complete gap analysis of all work streams that intersect with revenue cycle working with corporate resources, clinic operations including leadership; and other area leaders to ensure all gaps are closed.
Responsible to review monthly KPI’s and communicate problematic trends for intervention and resolution with corporate including leadership as appropriate.
Responsible for working knowledge of payer fee-for-service contracts and value-based care contracts.
Possess ability to work in a matrix environment where multiple or competing customer demands are likely.
Performs other duties as assigned.
Maintains regular and reliable attendance.
Complies with all policies and standards.
Provides leadership, mentorship and professional development opportunities for departmental staff.
Schedules employees to ensure effective use of resources. Consults with leadership on any potential staffing issues.
Conducts performance evaluations, sets goals and provides feedback to staff on their performance and development.
Collaborates with hospital leadership to set the strategic direction for the department, including budgeting, resource allocation and long-term planning.
Monitors expenditures, ensuring cost-effective delivery of services.
Evaluates and implements new technologies to enhance operational efficiency.
Develops and implements departmental policies and procedures and protocols to optimize quality and overall efficiencies.
Ensures compliance with all relevant regulatory bodies. May oversee the accreditation process with relevant agencies ensuring that services meet or exceed industry standards.
Participates in audits, inspections and accreditation processes as applicable.
Follows established quality control practices to ensure accuracy, consistency and safety.
Works closely with leadership teams to coordinate and improve service delivery.
Stays up-to-date with industry advancements, new technologies, and regulatory changes.
May work in a staff role, when required. Ensures that duties and responsibilities are fulfilled while meeting all competencies established for that job.