To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
Under the broad guidance of revenue cycle and revenue management leadership, this position will play an integral role in the establishment and execution of the strategic direction for the implementation of revenue reporting and revenue cycle initiatives across the Health System, including NEMG. Support the fiscal integrity of the System by assisting in the development and execution of policies and procedures that center on all aspects of the revenue management function on a system-wide basis.
In order to be an effective member of the revenue management team, possess strong technical proficiency in all aspects of revenue cycle, related to both professional and hospital billing which will allow for the effective execution of System-wide revenue cycle initiatives. Must have a demonstrated knowledge of regulatory requirements related to reimbursement, HIPAA, chargemaster, third party payors, insurance benefits, and a skill set for healthcare revenue cycle and financial information technology applications, which includes the ability to work with large data set files.
Responsible to drive processes for the identification and measurement of new opportunities for revenue enhancement and provide leadership to staff on numerous, simultaneous projects, and coordinates the work of other colleagues on same. Works closely with clinical management and other members of senior management on revenue cycle enhancements and denial management reporting.
Perform in a leadership role to promote the key concepts of customer satisfaction, due diligence, accountability, and teamwork to provide effective oversight over the revenue management process.
- 1. Responsible for working with revenue cycle and revenue management leadership in the development of the overall revenue cycle goals for the System , which includes setting processes and outcome metric goals as well as monitoring the progress compared to established targets.
- 2. Provide direction with respect to the development of and execution of work plans designed to achieve established revenue cycle goals.
- 3. Oversees multiple initiatives to direct and improve System revenue cycle operations that favorably impact accounts receivable, cash acceleration and net revenue.
- 4. Fosters excellent payor relations with key fiscal intermediaries, including government oversight agencies.
- 5. Serve as a catalyst for the coordination of revenue cycle initiatives, which include implementing strategies and leading margin enhancing process changes relating to revenue cycle on a System-wide basis. This process will ensure that a common vision, plan and goal are maintained System-wide.
- 6. Ability to create a collaborative work environment between System Business Office employees and Revenue Management that will enhance business operations, productivity, and effectiveness.
- 7. Lead the effort to monitor, track and report on the overall denial process in conjunction with the System Business Office.
- 8. Leads other multi-disciplinary work groups in revenue enhancement projects including various clinical areas, Coding, Medical Records, Hospital and Professional Billing, Contracting, Compliance and Information Systems with the overall goal to maximize System-wide revenue opportunities.
- 9. Collaborate with physicians to ensure key productivity metrics are achieved and revenue targets are maintained.
- 10. Cultivate a strong partnership with Corporate Compliance to assist in the identification of exposures and the development of strategies to ensure the appropriate amount if reimbursement from payors as well as to prevent violations of the False Claims Act, the Stark Law, HIPAA and the Anti-Kickback Statues.
- 11. Provide oversight in the development of Senior Management and Board level reports and presentations that relate to System revenue-cycle performance.
- 12. Provide oversight for the completion of financial forecasts and month-end financial reporting including monthly ?Dashboard? reporting which details the results against plan for a variety of key metrics relating to revenue cycle management for both Hospital and Professional billing. This analysis should be driven to identify and initiate revenue focused projects to enhance revenue cycle opportunities.
- 13. Provides direction to in the area of staff development by hiring and training staff to assume leadership positions by developing, maintaining and modifying work standards.
- 14. Communicates regularly and effectively with management and staff regarding the status of new revenue cycle initiatives and keeps management and staff updated and trained on compliance issues.
- 15. Adhere to all company policies and procedures.
- 16. Self-directed with the ability to collaborate with various stakeholders and teams and work in a fast paced environment with tight deadlines with the ability to effectively manage multiple priorities.
- 17. Perform other duties as assigned.
BA or BS in accounting or business, or equivalent experience. Master's degree in relevant field preferred.
Five to seven years' experience in health care finance, billing (Hospital and Professional), coding, direct clinical care, reimbursement, accounting, budget, compliance or insurance required with progressive responsibility in accountability, leadership, supervision, and project management.
Considerable knowledge of health care revenue process, database logic and management, and accounting is
required. Experience with large data sets and experience with decision support systems and cost accounting
theory related to healthcare is required. Experience with Hospital and Professional billing revenue cycle is required. Demonstrated ability to lead groups and work on numerous projects simultaneously. Previous management experience is preferred. Ability to influence and direct the thinking of others and deal with all levels of management and different types of staff.