ASSISTANT DIRECTOR, REVENUE CYCLE, MIT Medical
Reports to: Executive Director
The Assistant Director, Revenue Cycle is responsible for providing strategy, decision support, organizational planning and operational leadership in support of driving revenue cycle related activities. The position is responsible for the proactive management of the end-to-end coding and billing process for all clinical services, including a thorough understanding of systems, process and service-specific coding and billing requirements. The role is expect to proactively identify, develop and execute opportunities for revenue cycle improvement initiatives. The role also provides leadership to the billing and coding team, supported by a through understanding and use of standard operational, financial, billing and budget statistics and/or KPIs on a monthly basis. The Assistant Director is also responsible for ongoing communications to clinical staff regarding coding and billing best practices, guidance on individual and service level improvements and supporting the organization’s overall financial goals and performance.
Principal Duties and Responsibilities:
- Understands the implication of each element in the revenue cycle, and develop strategic plan for interventions and best business practice.
- Develops standardized approaches for operational issues, reporting, and analysis and quality management. Reviews key measures on a regular basis and develops new measures as needed. Develops expertise in querying system for data and reports. Works closely on interface and system issues as required to improve flow of data.
- Provides updates on global issues regarding coding and reimbursement practice(s).
- Assesses impact of new regulations or codes from a coding, compliance and reimbursement perspective.
- Works with Executive Director and Director of Financial and Budget on budgeting, forecasting and analysis.
- Establishes and develops collaborative relationships with internal staff, both clinical and administrative. Works with departments to modify procedures and update information (i.e. billing instructions, coding dictionary, etc.). Shares information with staff to enhance departmental efficiency/performance (i.e. notify of audit and compliance risks, identifies issues through rejection or receivable analysis.).
- Works in partnership with Medical Informatics team to manage and update revenue cycle elements of the practice management system(s) and/or electronic health record
- Directly manages and oversees the staffing, training, support, and development of the revenue cycle team, including registration, coding review, billing, claims management and denial management.
- Develops, implements, evaluates management and workflows within the department that enhances communication among employees, promotes good service to patients, and is integrated into the rest of the Department. Updates as appropriate.
- Ensures training and support for clinicians and patient service representatives, RNs, and other key stakeholders is provided on effective documentation, coding, and if appropriate, patient registration.
- Develops, implements, evaluates management systems that ensure appropriate follow – up occurs according to service guidelines. Develops action and contingency plans to correct bottlenecks, backlogs, etc., to reach productivity and collection goals.
- Responsible for accurate and timely billing, data entry, charge corrections, payment entry, adjustments, invoice corrections, pre-registration and collections.
- Ensures that all regulatory requirements are met and that coding is being performed in a compliant manner.
- Generate specific management reports and customized key billing metrics for dissemination to the Executive Leadership Team.
- All other duties as assigned.
Minimum Required Education and Experience:
- Bachelor’s degree or equivalent experience
- 7-10 years’ experience in healthcare billing and coding, including managing a billing/coding team
- Experience and understanding of healthcare coding, billing, finance and accounting principles
- Analytical and troubleshooting skills with good interpersonal and customer service skills
- Be able to manage multiple, complex projects simultaneously
- Demonstrate strong verbal and written communication competence, including demonstrated experience in presentation to diverse audiences up to executive level
- Experience working across a team tasked with design and implementation of cloud concepts and services
- Strong interpersonal and communication skills
- Ability to communicate effectively in writing
- Experience with Cerner Revenue Cycle Manager platform
- Professional certification in coding or billing (e.g., CPC, CPB)
Grade level: 9