Job description

Hospital Revenue Cycle Director

We are seeking a hospital Revenue Cycle Director who will be responsible for all functions that contribute to the capture, management, and collection of patient service revenue.

Duties include enhancing and maintaining a properly functioning revenue cycle process through a cross-department organizational structure. This position directs the operations of patient scheduling, registration, verification, Clinical Documentation Management Program, patient accounting and collections, reimbursement denial management, patient information management and charge description master file maintenance. This person also works with departments on their processes for charge capture and reconciliation.

ESSENTIAL DUTIES AND RESPONSIBILITIES (Other duties may be assigned):

1. Develop and implement standards, processes and controls for all billing activities to ensure a timely, correct and appropriate revenue cycle process.

2. Standardize revenue cycle reporting to include benchmarks and key performance indicators for departments reporting to revenue cycle.

3. Request, prepare and maintain reports on billing, coding, utilization and collection activities.

4. Educate management and staff on revenue cycle standards and provide timely feedback of key performance indicators.

5. Maintain up-to-date expertise and knowledge of the healthcare industry including billing laws, rules, regulations, and developments necessary for the organization to make informed business decisions.

6. Works with departments on their processes for charge capture and reconciliation.

7. Monitors the unbilled accounts, works with HIM director to minimize the unbilled accounts.

8. Manages and implements chart audit process.

9. Directs the Charge Master and Denial Management committees. Identify, examine and analyze patterns of rejections, partial denials, or denials from third party payers and implements change.

COMPLIANCE RESPONSIBILITIES:

Understands and adheres to the Hospital’s compliance standards as they appear in the Compliance Policy, Code of Conduct and Conflict of Interest Policy. Keeps abreast of all pertinent federal, state and Hospital regulations, laws, and policies as they presently exist and as they change or are modified.

JOB REQUIREMENTS:

Knowledge of accounting principles and techniques normally acquired by completing a Bachelor’s degree in accounting or closely related field in order to understand the impact of the revenue cycle on the performance of the hospital. In depth knowledge of hospital charging and billing practices normally acquired through 3 or more years’ experience in a department that performs revenue cycle functions (e.g., patient accounts, registration, coding, etc.) in order to understand revenue cycle issues.

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