Director of Revenue Cycle

Director of Revenue Cycle

Requirements

• Kaweah Health approved crisis intervention training within 60 days of hire/transfer
• Bachelor’s degree in business related field
• A minimum of five years experience as a Patient Accounting or Patient Access Department Manager at a progressive healthcare institution similar in size and complexity as the Kaweah Health
• Strong organizational, managerial, communication and customer relation skills
• Proficiency with financial software applications.

Responsibilities

• Organizes and directs the activities of the Patient Access and Patient Accounting Departments, ensuring that all efforts provide value to and meet the needs of their customers.
• Ensures that all policies and procedures relating to functions within the Patient Access and Patient Accounting Departments are consistent with applicable laws, regulations and sound business practices. Confidentiality of patient information shall be maintained without exception.
• Creates an interdisciplinary focus of performance improvement and quality management. Responsible for leading assigned operational planning to identify and reach short and long term goals.
• Provides a highly-collaborative working environment for Patient Access and Patient Accounting to maintain an efficient and effective registration and billing function for the organization.
• Ensures adherence to internal controls and audit functions developed by the Kaweah Health’s independent accounting firm and the Finance Division.
• Serves as the liaison to Clinical Department Heads to provide feedback on revenue integrity, charging processes, reimbursement, denials, services performed without medical necessity as defined by payer regulations, missing documentation needed to code appropriately, coding compliance and timeliness, missing and late charges, and other business aspects associated with care provided.
• Integrates departmental services with the Kaweah Health’s operational initiatives.
• Develops and implements policies and procedures consistent with the Kaweah Health’s Mission that guide and support the Provision of Services Plan.
• Continuously assesses and improves department performance utilizing past performance and industry standard KPI’s.
• Provides orientation, in-services and continuing education for staff and management.
• Responsible for maintaining ongoing knowledge of regulations, practice standards, trends and opportunities in all aspects of admitting, registration, scheduling and billing/patient accounting and understands the compliance of such regulations and standards.
• Enhances professional growth and maintains awareness of current industry trends, legislation or research which could impact assigned departments and functions and the Kaweah Health.
• Assists in the recruitment of highly-competent staff and management. Evaluates individuals functioning below expectations to create improvement plans to realign performance within acceptable norms.
• Maintains job descriptions to accurately reflect the responsibilities and standards for all staff and management positions.
• Documents policies and procedures reflect current practice.
• Maintains good relationships, communication and cooperation with other departments, patients, families, and physicians and their staff. Understands and articulates Kaweah Health strategic and financial directions to staff and others. Communicates clearly and concisely in speech and writing through body language, tone of voice and effective listening.
• Prepares annual department budgets. Monitors and analyzes financial performance monthly and controls expenditures in accordance with the annual budget.
• Responsible for ensuring that all phases of patient accounts receivable relative to charging and billing are in full compliance with applicable laws. Is the resource for information required by all revenue generating departments in order to establish their charging and billing structure. Provides necessary training when requested or as required.
• Responsible for meeting billing requirements of all third-party payors and coordinating billing requirements with all Kaweah Health departments. Ensures that amounts collected are in compliance with applicable third-party contractual arrangements.
• Responsible for ensuring maintenance of all master and table files of computer software systems controlling accounts receivable. Ensure the effective use of available computer systems and applications. Works with other departments to ensure that the applications interfaced to the accounts receivable systems are within approved standards of legal compliance, general accounting rules and efficient collections of A/R. All functions impacting the Patient Accounting and General Accounting systems are documented (i.e., time of batch submissions, uploads and file reorganization).
• Provides leadership, direction and motivation to ensure that Patient Access services meet the needs of our customers through collection and timely reporting of accurate patient information.
• Is accountable for all planning, implementation, operation and evaluation of Patient Access services including patient admissions, emergency department registrations, outpatient scheduling, pre-certification/authorization/benefits, financial counseling, and outpatient registrations.

Preferred Qualifications

• Master’s degree