Integrative Emergency Services, LLC (“IES”) is dedicated to cultivating best practices in emergency care, providing comprehensive acute care services, creating value, and supporting patients, employees, clients, providers, and physicians in pursuit of the highest quality health care.
Position Summary
Responsible for the general supervision and management of the billing and revenue cycle functions for numerous physician practices. The Director of Billing and Revenue Cycle will oversee the insurance billing, coding and collections policies as well as objectives and initiatives of the organization’s activities. Responsible for developing solutions for increasing cash collections, reducing denials and increasing the overall effectiveness of the revenue cycle management (RCM) service line.
Essential Duties and Responsibilities
Overall responsibilities
- Plan, develop, organize, implement, direct and evaluate systems, processes and payor specific reimbursement mechanisms and billing requirements, contributing in the proactive identification of opportunities for revenue cycle improvement and enhancement.
Develop appropriate policies and programs for effective management of the billing and revenue cycle management of all physician groups. - Oversee and manage the performance and development of all MSO processes.
- Develops reports and analyzes data to plan, organize, manage, and control collection processes.
- Analyzes prepared reports and data to identify trends related to denials and rejections; develops and executes plans to avoid, reduce, and resolve denials and rejections.
- Reviews, analyzes and interprets financial data to monitor progress towards established goals, identifies deterrents to success and implements improvements as necessary to enhance efficiencies and results.
- Provides direction and coordination for the development and implementation of performance and quality improvement processes for the physician revenue cycle.
- Oversees resolution of escalated issues with third party payors.
- Stays current on all managed care, Medicare, Medicaid, and other payor regulations that impact billing activities.
- Interprets and presents revenue reports to physicians and key decision makers.
- Serves as the subject matter expert for revenue cycle service excellence, maintaining an active understanding of current thinking and innovative interventions/programs regarding the patient revenue cycle experience, including identifying how top performing health systems identify and maintain success.
- Manage the budget and other financial measures for the department.
- Perform other duties as assigned.
Job Requirements/Specifications
Education and Experience: The requirements listed below are representative of the knowledge, skill, and/or ability required.
Required:
- Minimum five (5) years of Hospital or Physician Practice Revenue Cycle management required.
- Bachelor’s degree in Business Administration, Accounting, Healthcare Administration, Finance, or related field.
- Minimum of 10-15 years’ experience in professional services and hospital coding, billing and collecting.
- Strong knowledge of various EMR systems including but not limited to: EPIC, MedHost, Cerner and Allscripts.
- Strong analytical skills required
- Advanced computer skills required
- Strong knowledge of health plan requirements
- Previous supervisory experience
Preferred:
Master’s degree in Health Systems Management or Business Administration preferred
Essential Qualifications:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.
- Strong communication, interpersonal and organizational skills
- Ability to manage multiple priorities
- Strong customer service orientation
- Confidentiality
- Language Skills
- Ability to read, write and speak English proficiently
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.
- Specific vision requirements include the ability to see at close range, distance vision, peripheral vision, depth perception, and the ability to adjust focus
- While performing the duties of this job, the employee is regularly required to talk and hear
- Frequently required to stand, walk, sit, use hands to feel, and reach with hands and arms
- Possess the ability to fulfill any office activities normally expected in an office setting, to include, but not limited to: remaining seated for periods of time to perform computer-based work, participating in filing activity, lifting and carrying office supplies (paper reams, mail, etc.)
- Occasionally lift and/or move up to 20-25 pounds
- Fine hand manipulation (keyboarding)
Work Environment:
- The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.
- Office environment
- May visit hospital locations
- The noise level in the work environment is usually low
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.