VP, Revenue Cycle

Position location: You will be able to work from your home location within the United States.

Position specific details: As a key member of the Revenue Cycle leadership team this role will have direct oversight and responsibility for all processes related to the front-end services of the patient revenue cycle. This includes insurance verification, electronic intake and authorization. This role is fundamental to the start of the revenue cycle lifecycle and our interaction with patients. In addition, will interface with key stakeholders in Admissions, Managed Care and Insurance Coordinators. The VP of Revenue Cycle will have oversight that encompasses associates domestically and with our global partners to partner to ensure all initial processes in the Revenue Cycle are executed in adherence to the company’s goals. Domestic and International travel required.

PURPOSE AND SCOPE:
Supports US Vascular/Fresenius Vascular and FMCNA’s mission, vision, core values and customer service philosophy.  Adheres to the FMCNA Compliance Program, including following all regulatory and FMS/USV/FVC policy requirements.   Oversees all A/R functions for USV/FVC facilities to provide timely collections on A/R balances due the company and properly administers write-offs relating to bad debt in accordance with all applicable company, industry, and regulatory requirements.  Implements cost containment strategies as appropriate.  Responsible for assuring proper implementation of all state and federal regulatory requirements applicable to the specific provider type and assisting with evaluation of reimbursement and coding from Federal and Private Payers for vascular access services. Oversees compliance with FMCNA Compliance Policies, governmental processing and reporting requirements to ensure external reporting is timely and accurate.  Oversees and monitors payer contracting functions for all Access Site locations.  Oversees and monitors intake process including patient registration and insurance verification for all Access Site locations.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• Reimbursement
  • Monitors the day to day functions of the Patient Intake, Billing, Cash Posting and Accounts Receivable departments
• Ensuring appropriate internal controls, timeliness, accuracy, and adherence to Corporate and governmental policy is maintained.
• Ensuring that patient accounts are correctly billed to the appropriate payer and that revenue is properly recognized.
• Monitoring daily deposits via cash posting department for accuracy.
• Overseeing the monthly close process of the Advantx and Medical Manager sub-systems and providing the accounting department with cash deposits, projected revenue, aging, bad debt, physicians’ compensation, patient mix and various standard reports.
  • Assuring reporting to Access Site locations of incorrect intake information and proper needed resolution.
  • Reviewing and monitoring routine follow-up activities of unpaid claims team for effectiveness;  setting performance measurements to improve collections performance;
  • Identifying, addressing and resolving USV related billing concerns.
  • Communicating with the relevant personnel and management regarding all major issues impacting billing operations and collections.
  • Participates in team meetings with Intake, Denial Management, Billing, Cash and Follow up teams to assure proper direction is obtained.
  • Assuring compliance with Medicare/Medicaid requirements and regulations by:
  • Maintaining current knowledge on Medicare, Federal, State and local regulations including reimbursement and procedure coding. 
  • Providing the appropriate personnel with CPT codes including ICD-9m correct coding initiatives and other valid updates. 
  • Reviewing interventional procedures to ensure maximum reimbursement is recognized and billed accordingly within Correct Code Initiatives guidelines as mandated by Medicare.
  • Assures the correct setup and utilization of billing software (Advantx/Medical Manager) and maintains system security and access ensuring compliance with FMS policies and regulatory requirements.
  • Monitors Accounts Receivable trends closely and addresses any collection issues including monitoring days outstanding to maximize cash flow and decrease Bad Debt Expenses.
  • Ensures correct fee schedules and pricing information are loaded into software application working with the appropriate personnel to resolve any system issues.
  • Addresses and resolves complex third party payer issues as escalated by billing staff.
  • Assures development and maintain training of Front Desk Coordinators as it relates to importance of correct information being collected, insurance verified