Ryan Health
Overview
Under the direction of the Chief Financial Officer (CFO), the Revenue Cycle Director effectively leads billing, collection, compliance, and accounts receivable management while maintaining a full understanding of Ryan Health Network’s billing system and all aspects of community health center revenue cycle management. The Director will manage the activities of the centralized billing and collection staff by overseeing all billing and accounts receivable functions. Billing will include payer sources such as: Managed Care, Medicare, Private Insurance, Private Pay, and other third party in accordance with established policies and procedures. This individual will create and implement policies and procedures toward productive function of department; implementation and monitoring of performance goals and objectives; ensure accurate posting of financial activity; maintenance of good interdepartmental communication. This work is carried out in support of the mission and goals of Ryan Health Network.
WORK SCHEDULE:
Mon - Fri: 9am - 5pm
Essential Functions
Direct staff to ensure that accurate submission of all claims and timely collections occurs in accordance with established internal and third-party payer requirements and in compliance with established policies, regulations, procedures and standards.
Establish and maintain all billing and financial data, including medical billing code tables, rate schedules and payer information.
Maintain, analyze and report on key revenue metrics and departmental and payer revenue performance indicators, proactively communicating and solving revenue-related issues; identify trends for further review.
Ensure timely and accurate billing and collections activity. This includes assisting staff members who are backlogged and ensuring the proper distribution of work throughout the department.
Assure maximization of cash collections through diligent and timely monitoring of all open accounts receivable balances.
Prepare detailed analyses and reports of billing and accounts receivable activity and results, including performance metrics, bad debt expense, denials management and AR days outstanding. Review and analyze aging reports on a monthly basis; assist in receivable process accordingly. Distribute aging reports to staff for follow up on billing activities. Ensure that the Advanced Collection program is appropriately utilized to maximize collection.
Maintain, enhance and ensure billing practices are in compliance with policies and procedures for each function in the revenue cycle process and ensure staff adherence to policies.
Serve as a liaison between the CFO, Finance Department and clinical departments on billing and revenue cycle matters; enhance awareness of providers on ways to strengthen revenue cycle performance; train First Impression Representatives and other patient service representatives to improve revenue generation efficiencies.
May assume some direct billing/collections responsibility as a working supervisor with the workload approved by the CFO.
Establish and implement annual goals and performance standards for all billing functions that align with Ryan Health’s vision and business goals; identify external benchmarks and provide complete analysis and make suggestions for improving performance and goals.
Provide mentoring, coaching and performance review of billing staff.
Manage all billing operations, including hiring, orientation, training, development, coaching, corrective actions, and ongoing monitoring of all staff work-related activities. Attend leadership and provider meetings.
Ensure consistent quality of the billing services by distributing and assigning duties and responsibilities to employees, ensuring skill levels are appropriate to the assigned tasks, and monitoring the department’s productivity.
Establish collaborative relationships with Medicare managed care organizations and insurance companies to solve problems and improve reimbursements.
Maintain accurate ICD-9/ICD-10 and CPT codes and keep abreast of updates and changes to ensure proper medical coding and billing procedures.
Review the closing of the month and run all reports needed and as required by regulations and funding agencies.
Ensure that reports are balanced and numbers posted match the activity done.
Prepare reports and information needed for any reconciliation by funding programs.
Provide or facilitate training for billing as appropriate, front office personnel.
On a temporary basis, may be required to work at any satellite facility.
Serves and protects the practice by adhering to professional standards, policies and procedures, federal, state, and local requirements including OSHA, HIPAA, and CLIA, and The Joint Commission Accreditation of Healthcare Organization standards.
Perform other related duties, which may be inclusive, but not listed in the job description.
Minimum Experience And Skills Required
A minimum of three (3) years management experience, both department operations and staff.
Demonstrated knowledge of billing and specialty programs such as CHDP, CDP, SOFP, Managed Care, Medicare and Private Insurance.
Must have thorough knowledge, training, and experience in using medical/dental terminology.
Must be computer literate and have working knowledge of computerized billing, practice management systems, and MS Office Suite (e.g. Word, Excel, etc.).
Be self-motivated and have the ability to prioritize work and meet deadlines.
Strong customer service skills (preferably within a service industry) and maintain an effective and positive working relationship with staff and customers.
Knowledge of federal laws and regulations affecting coding requirements.
Excellent oral and written communication skills – be able to provide information in a clear and concise manner; good interpersonal skills.
Ability to be flexible with work schedule and available to work at all site locations.
Education, Licenses And/or Certifications Required
A minimum of two (2) years of college and/or an Associate Degree with at least three years work experience in medical billing and collections or at least five (5) years work experience in medical billing and collections.
Preferred Qualifications
Knowledge of billing practices required, FQHC billing preferred.
Knowledge of Electronic Health Records – eClinicalWorks (eCW) experience strongly preferred.
Competencies Required Customer Service:
Professional, courteous and respectful attitude in interacting with patients.
Demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patient served.
Commits to exceeding expectations of the patient.
Cooperation/Teamwork
Provides clear guidance and expectations.
Works well with others.
Contributes input to management to improve outcomes.
Asks others for opinions and feedback; provides feedback in a tactful respectful way.
Minimal Training Time 180-day probationary period.
Working Conditions Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to sit, stand, talk and hear. The employee is occasionally required to move about the office; use hands and fingers to feel, handle, or operate office equipment. Specific vision abilities required by this job include close vision and the ability to adjust focus.
Work Environment: The work is primarily in an ambulatory and/or general primary care setting which includes the unpredictability in behaviors of individuals and acute and chronic infectious diseases which may be contagious. Adequate preparation and precaution is necessary.
Disclaimer The duties listed above are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment to the position. This position may be required to perform other duties. If such work becomes a permanent and regular part of the job, a new description will be prepared.
Equal Opportunity Employer Ryan Health is an Equal Opportunity Employer and does not discriminate on the basis of age, color, disability, ethnicity, marital or family status, national origin, race, religion, sex, sexual orientation, gender identity, military veteran status, or any other characteristic protected by law.
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WORK SCHEDULE:
Mon - Fri: 9am - 5pm
Essential Functions
Direct staff to ensure that accurate submission of all claims and timely collections occurs in accordance with established internal and third-party payer requirements and in compliance with established policies, regulations, procedures and standards.
Establish and maintain all billing and financial data, including medical billing code tables, rate schedules and payer information.
Maintain, analyze and report on key revenue metrics and departmental and payer revenue performance indicators, proactively communicating and solving revenue-related issues; identify trends for further review.
Ensure timely and accurate billing and collections activity. This includes assisting staff members who are backlogged and ensuring the proper distribution of work throughout the department.
Assure maximization of cash collections through diligent and timely monitoring of all open accounts receivable balances.
Prepare detailed analyses and reports of billing and accounts receivable activity and results, including performance metrics, bad debt expense, denials management and AR days outstanding. Review and analyze aging reports on a monthly basis; assist in receivable process accordingly. Distribute aging reports to staff for follow up on billing activities. Ensure that the Advanced Collection program is appropriately utilized to maximize collection.
Maintain, enhance and ensure billing practices are in compliance with policies and procedures for each function in the revenue cycle process and ensure staff adherence to policies.
Serve as a liaison between the CFO, Finance Department and clinical departments on billing and revenue cycle matters; enhance awareness of providers on ways to strengthen revenue cycle performance; train First Impression Representatives and other patient service representatives to improve revenue generation efficiencies.
May assume some direct billing/collections responsibility as a working supervisor with the workload approved by the CFO.
Establish and implement annual goals and performance standards for all billing functions that align with Ryan Health’s vision and business goals; identify external benchmarks and provide complete analysis and make suggestions for improving performance and goals.
Provide mentoring, coaching and performance review of billing staff.
Manage all billing operations, including hiring, orientation, training, development, coaching, corrective actions, and ongoing monitoring of all staff work-related activities. Attend leadership and provider meetings.
Ensure consistent quality of the billing services by distributing and assigning duties and responsibilities to employees, ensuring skill levels are appropriate to the assigned tasks, and monitoring the department’s productivity.
Establish collaborative relationships with Medicare managed care organizations and insurance companies to solve problems and improve reimbursements.
Maintain accurate ICD-9/ICD-10 and CPT codes and keep abreast of updates and changes to ensure proper medical coding and billing procedures.
Review the closing of the month and run all reports needed and as required by regulations and funding agencies.
Ensure that reports are balanced and numbers posted match the activity done.
Prepare reports and information needed for any reconciliation by funding programs.
Provide or facilitate training for billing as appropriate, front office personnel.
On a temporary basis, may be required to work at any satellite facility.
Serves and protects the practice by adhering to professional standards, policies and procedures, federal, state, and local requirements including OSHA, HIPAA, and CLIA, and The Joint Commission Accreditation of Healthcare Organization standards.
Perform other related duties, which may be inclusive, but not listed in the job description.
Minimum Experience And Skills Required
A minimum of three (3) years management experience, both department operations and staff.
Demonstrated knowledge of billing and specialty programs such as CHDP, CDP, SOFP, Managed Care, Medicare and Private Insurance.
Must have thorough knowledge, training, and experience in using medical/dental terminology.
Must be computer literate and have working knowledge of computerized billing, practice management systems, and MS Office Suite (e.g. Word, Excel, etc.).
Be self-motivated and have the ability to prioritize work and meet deadlines.
Strong customer service skills (preferably within a service industry) and maintain an effective and positive working relationship with staff and customers.
Knowledge of federal laws and regulations affecting coding requirements.
Excellent oral and written communication skills – be able to provide information in a clear and concise manner; good interpersonal skills.
Ability to be flexible with work schedule and available to work at all site locations.
Education, Licenses And/or Certifications Required
A minimum of two (2) years of college and/or an Associate Degree with at least three years work experience in medical billing and collections or at least five (5) years work experience in medical billing and collections.
Preferred Qualifications
Knowledge of billing practices required, FQHC billing preferred.
Knowledge of Electronic Health Records – eClinicalWorks (eCW) experience strongly preferred.
Competencies Required Customer Service:
Professional, courteous and respectful attitude in interacting with patients.
Demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patient served.
Commits to exceeding expectations of the patient.
Cooperation/Teamwork
Provides clear guidance and expectations.
Works well with others.
Contributes input to management to improve outcomes.
Asks others for opinions and feedback; provides feedback in a tactful respectful way.
Minimal Training Time 180-day probationary period.
Working Conditions Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to sit, stand, talk and hear. The employee is occasionally required to move about the office; use hands and fingers to feel, handle, or operate office equipment. Specific vision abilities required by this job include close vision and the ability to adjust focus.
Work Environment: The work is primarily in an ambulatory and/or general primary care setting which includes the unpredictability in behaviors of individuals and acute and chronic infectious diseases which may be contagious. Adequate preparation and precaution is necessary.
Disclaimer The duties listed above are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment to the position. This position may be required to perform other duties. If such work becomes a permanent and regular part of the job, a new description will be prepared.
Equal Opportunity Employer Ryan Health is an Equal Opportunity Employer and does not discriminate on the basis of age, color, disability, ethnicity, marital or family status, national origin, race, religion, sex, sexual orientation, gender identity, military veteran status, or any other characteristic protected by law.
#J-18808-Ljbffr