Director Revenue Cycle Management at Waterbury Hospital – Middlebury, Connecticut

SCOPE OF POSITION:

In this role, you will be responsible for directing the medical coding, billing, accounts receivable and audit functions for MPP clients. You will be responsible for identifying trends and opportunities for improvement to enable MPP and its clients grow revenue and profit.

ESSENTIAL DUTIES and RESPONSIBILITIES:

Disclaimer: Job descriptions are not intended, nor should they be construed to be, exhaustive lists of all responsibilities, skills, efforts or working conditions associated with the job. They are intended to be accurate reflections of the principal duties and responsibilities of this position. These responsibilities and competencies listed below may change from time to time.

• Direct staffing resources to enhance performance of coding, billing and accounts receivable operations
• Establishes productivity metrics and benchmarks for RCM staff
• Develop and implement mechanisms and controls to ensure appropriate billing and payment cycles and accurate and timely billing, in accordance with established internal and third party payor requirement
• Establish and record in writing and implement appropriate billing policy procedures and procedures for all billing activities including follow-up on third party approvals and collection of overdue patient accounts
• Direct and monitor charge posting, billing and collection operations for compliance with established policies, regulations, procedures and standards
• Manage actions relating to delinquent accounts, collection agencies, special adjustments and/or write off’s
• Request, prepare and/or maintain both recurring (I.e. dashboards) and ad hoc reports on all Revenue Cycle activities
• Manage the implementation and ongoing maintenance/management of all HL7 interfaces (ADT, SIU, and DFT) required by MPP clients
• Manage and maintain all RCM system applications including Allscripts PRO PM File Maintenance (to include but not limited to adding/editing Providers, Insurance Carriers, CPT Codes, Diagnoses, Practice Locations), Allscripts Interface Engines, PM system Upgrades, RCx Rules, and Precision BI.
• Oversee MPP’s Coding Audit & Education business line including the preparation and delivery of audit results to MPP clients
• Oversee and manage the onboarding of new clients and/or practices
• Represent MPP at business meetings with billing partners, client’s and other related organizations
• Manage the processing of all personnel actions; perform performance evaluations and initiates correction action plans when appropriate
• Analyze operational volume to determine appropriate staffing requirements
• Maintain up to date expertise and knowledge of healthcare billing laws, rules, regulations and developments necessary for the organization to make informed business decisions
• Develop and deliver organized, concise yet thorough communications to executive leadership regarding proposed changes, developments and opportunities affecting the organization and billing department
• Performs Annual employee reviews for direct reports
• Recruit local market RCM managers as needed

Qualifications:

• Education and Experience:
  • High School diploma or GED required
  • MA/MS degree desirable
  • 10+ years experience in medical billing and patient account management
  • 5+ years of Management experience
• Personal qualities: innovation, resourcefulness, independence, enthusiasm, self confidence.
• Broad understanding of medical practice management, coding, operations and billing.
• Demonstrated skills in problem resolution and proven track record in receivable management.
• Must have expertise in medical insurance billing, ICD-10, CPT and E & M coding.
• Encourages teamwork; energetic and motivates teams and individuals.
• Excellent analytical and problem solving skills.
• Ability to work effectively with a broad range of internal and external customers.
• Excellent oral and written communication skills.
• Excellent organizational and time management skills.
• Demonstrated ability to work both independently and within a team.
• Demonstrated ability to handle multiple assignments simultaneously.
• Demonstrated ability to lead others toward objectives without direct reporting relationships.

Disclaimer

Waterbury Hospital reserves the right to change or assign other duties and responsibilities to this position