POSITION: Assistant Director, Business Office/Revenue Cycle
POSITION SUMMARY: Manages, directs and coordinates activities of personnel engaged in revenue cycle, including billing, collecting, coding, credentialing and registration. Works directly with management and administration to enhance the efficiency of the revenue cycle process. Develops and implements policies, procedures and standards of performance for departmental operations. Establishes measureable and achievable goals and objectives for areas of responsibility. Oversees the continuous process improvement of revenue initiatives utilizing key internal data. Coordinates and collaborates with leadership to ensure timely resolution to revenue cycle issues. Tracks revenue cycle metrics and associated benchmarks to identify and replicate best practice improvement opportunities.
POSITIONS SUPERVISED: Coding Supervisor, A/R Supervisor, Reimbursement Supervisor, Patient Accounts Supervisor, and Billing System Analyst
ESSENTIAL FUNCTIONS AND JOB RESPONSIBILITIES:
1. Oversees the development, maintenance, implementation and training of protocols, policy and procedures for all functions related to the revenue cycle.
2. Managing and coordinating continued education of the coding auditors and the coding team members.
3. Remains up to date on ICD-10, CPT4, HCSPCS Level II and third-party coding and reimbursement guidelines and regulations.
4. Meets with Physicians and Mid –Level Providers to assist with reviewing results of coding audits with them in accordance with clinic policy for compliance with governmental and third party regulations.
5. Evaluates available coding computer applications and software.
6. Verbal ability and interpersonal skills to communicate effectively coding guidelines and audits results to the providers.
7. Analyze, prepare and present revenue cycle reports to the appropriate management and administration.
8. Identify, examine, and analyze patterns of rejections, partial denials, or denials from third party payers and implement changes. Reports trends to Business Office Director
9. Ensure department is represented at committee meetings and provide valuable feedback to the area from these meetings.
10. Exhibits computer systems knowledge and proficiency as necessary to perform job functions.
11. Demonstrates the attitudes and behaviors of The South Bend Clinic Service Standards.
12. Performs other duties as assigned when appropriate.
13. Adheres to HIPAA guidelines set forth in Clinic policies and procedures.
Minimum of a Bachelor’s degree in a related field is required. Certified Professional Coder through AAPC, or AHIMA preferred.
Knowledge, Skills, and Abilities:
Minimum of 5 years Revenue Cycle experience. Proven and demonstrated experience of Contracting, ICD-10, and CPT Coding, medical billing, third party reimbursement including knowledge of Risk/Shared Savings and Capitation Contracts. Have proven and demonstrated experience in supervision of staff and project management.
Position requires: a) ability to perform simple mathematical equations; b) ability to use 10 key calculator proficiently; c) excellent verbal and written communication skills d) Intermediate/Advanced Excel Skills complex formulas (vlookups, if’s, etc) and pivot tables, e) Ability to handle multiple high-priority projects simultaneously f) Ability to demonstrate independent judgment and initiative. Must possess strong analytical and interpersonal skills, and relationship development.