Director of Revenue Cycle
Lake Success, NY - Posted on: Tuesday 06/21/16
ProHEALTH one of the largest private multi-specialty medical practices in the Northeast and has been serving the health needs of Long Island and the Greater New York Metropolitan area since 1997. Along with outstanding physician leadership, state-of-the art technology, and advanced clinical laboratories, ProHEALTH patients enjoy comprehensive and superior medical services at locations throughout Long Island and New York City.
Seeking an individual who is capable of transforming the revenue cycle process to a future state that encompassing the best technology, analytics and effectiveness. The ideal candidate needs to be experienced in Risk Based model.
The Director of Revenue Cycle is responsible to develop, plan, organize and implement current and future strategies to bill customers, process payments, minimize bad debt, improve cash flow and manage the overall health of the company’s receivables. This position is responsible for performance improvement of all aspects of revenue cycle including: billing, collections, outside contractor, patient accounting and other functions. The ideal candidate will ensure aggressive and efficient accounts receivable management, follow up and related vendor services, third party audits relative to claims, collection agency activities, and identification of issues to drive seamless billing via processes for system profiles, master files and conversion tables, vendor management, etc. This position will also be responsible for identifying and correcting operating issues that will maximize the effect on cash flow. The Director of Revenue Cycle will work with the practice office managers on revenue cycle performance to meet strategic goals, guidelines, policies, and procedures through analysis.
Essential Duties and Responsibilities:
The Director of Revenue Cycle is responsible for directing the activities of the Patient Billing & Collections Services, including but not limited to the following:
· Develops, organizes and implements overall billing, collection and payment reimbursement functions.
· Plans, directs, reviews, coordinates and evaluates through the functions of the department to increase positive cash flow, achieve operational efficiencies, and ensure compliance with established laws, regulations, practices and procedures.
· Monitors accounts sent for collection and reimbursements from insurance companies and other third party payers.
· Manages the development and implementation of departmental policies and procedures
· Attends, participates and provides constructive input as a member or leader of multidisciplinary activities or committees.
· Monitors and audits productivity goals, reviews level of progress and achievement, and exercises discretion and judgment when recommending and implementing measures for improvement.
· Works closely with Managed Care, Patient Access, Case Management, Budget and Reimbursement.
· Ensures education training and development of members of the Billing/Collection Payment Post/ Customer ServiceTeam.
· Quality/Improvement & Performance Audit
· Contract Management
· Analysis/Trending of payments, charges and identifying issues.
· Customer Service
· Working with Coding/ Compliance Collection agencies.
· Uses KPI’s to assure “Best Practices”.
· BS/BA or work related equivalent.
· MBA, or related advanced degree preferred.
· At least ten (10) years of leadership experience in patient accounting in a large health system, facility practice or multi-specialty group.
· Computer literate, proficient with Excel.
· Excellent oral and written communication and interpersonal skills with a customer-service focus required.
· Experience in implementing new practice management systems.
· Demonstrated ability in developing new workflows and transforming organizational culture.
· Proven experience in using analytical tools and applications.
Please email resume and salary requirements to email@example.com.
ProHEALTH is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.