Executive Director, Revenue Cycle at Illinois Bone and Joint Institute LLC – Park Ridge, Illinois

Organizational Profile

Founded in 1991, IBJI is the largest orthopedic group practice in Illinois. With more than 150

physicians in every orthopedic specialty, IBJI offers care for adults and children from some of

the most accomplished and respected orthopedists in the country. Serving northern Illinois and

northwest Indiana with over 100 locations, IBJI makes it easy to access care. Our headquarters

is in Park Ridge, Illinois, a northwest suburb of Chicago. Our clinical services include advanced

MRI imaging, pain management, non-surgical and surgical treatment plans, rheumatology,

physical therapy, occupational therapy, wellness, and sports and sports training. Ortho Access

walk-in clinics provide same day care for orthopedic injuries. Comprehensive care offered all in

one place enables physicians, therapists and staff to work closely together, so that patients and

families achieve better outcomes. Collaborative care is also more efficient. In many cases, IBJI

services are substantially less expensive than those provided by large healthcare systems and

emergency rooms.

Summary

Responsible for developing and directing revenue cycle management operations for Illinois Bone & Joint Institute. Develop strategies to optimize operations and revenue efficiency. Establish targets, policies, and internal controls that will drive improvements and efficiencies in overall service revenue capture and collection. Ensures compliance with regulatory requirements and responsiveness to changes in requirements. Coordinates with stakeholders across the organization to drive optimal financial performance.

Responsibilities

• Provides executive leadership, oversight and direction to the full revenue cycle function: reimbursement, coding & compliance
• Champions revenue cycle improvements throughout the organization include working with appropriate individuals to aid the resolution of identified revenue cycle issues.
• Develops and nurtures key relationships across IBJI. This role works closely with Compliance, Epic, physician leadership, practice administrators and executive team members to ensure alignment around key principles. Training, education, and proactive communication will be paramount.
• Builds a culture that balances the importance of compliance with active communication, education, and partnership.
• Reviews, designs, and implements processes to ensure operational efficiency of the revenue cycle function.
• Implements and monitors collection procedures, minimizing contractual and bad debt write-offs, and maximizing cash collections
• Tracks numerous metrics related to the revenue cycle including coding error rates, denials, accounts receivable to develop sound revenue cycle analysis and reporting
• Monitors analytical data of revenue cycle to be proactive in operations.
• Performs ongoing trend analysis of third-party payer rejects and denials. Develops training programs for registration, billing, and coding staff to eliminate/reduce rejects/denials
• Monitors and ensures adherence to payer guidelines and regulatory compliance.
• Manages payer and specialty contracts to ensure contract compliance
• Performs ongoing trend analysis on third party payer payments to ensure reimbursement is in accordance with allowable amounts stated in agreements and contracts. Works with appropriate individuals to resolve discrepancies
• Develop policies/procedures to support the functional infrastructure
• Provides financial support and analysis to physician practices through communication and education.
• Communicates actively with administrators, providers, and other individuals to proactively review specific coding and collection issues and mitigate elevated concerns.
• Participate actively in staff development and assessments to support industry best practice

Knowledge, Skills and Qualifications

• Bachelor degree in related field or equivalent experience.
• Certified coder preferred
• Minimum of ten (10) years of medical billing experience Minimum of five years in a supervisory role
• Knowledge of professional fee billing, reimbursement and third party payer regulations and medical terminology is required
• Knowledge of all regulatory reimbursement and insurance related requirements
• Strong working knowledge of medical terminology, CPT, HCPCS, ICD9 and ICD10
• A systematic approach to problem solving for all types of issues
• Strong skills in fostering working relationships
• Detail oriented; organized; sets priorities; meets deadlines
• Advanced skills in computer programs, particularly Microsoft Excel
• Effective and clear oral and written communication skills with individuals and groups

Supervisory Relationship

• Reports to Chief Operating Officer