Executive Director of Revenue Cycle Management

This position will support the effective and efficient operations of the GBMC Revenue Cycle for both Hospital and Professional Fee receivables and ensure continuous quality improvement efforts. This Position reports to the CFO and works with the CFO in the implementation and direction of the complete revenue cycle process across the hospital and all physician practices.

Education:
Master’s Degree required

Licensure:
CPA
Epic Certification Desirable

Experience:
10+ years managing Revenue Cycle Department in within a health system or large private practice.
Skills:
• Experience with latest generations of hospital receivable, practice management and EMR systems.
• Experience creating, implementing and maintaining Policies and Procedures for an organization or department with a minimum of 50 people.
• Experience managing multiple office locations.
• Experience managing all aspects of revenue cycle from initial patient contact through successful outcomes.
• Excellent Conflict Management Skills
• Advanced Computer Skills and Experience including high level excel reporting, importing data from billing software into reports, understanding of operating systems and programming language such as SQL.
• Strong leadership and communication skills.
• Experience with contract management systems desirable.

Principal Duties and Responsibilities:
• Ensures regular meetings of the RCM including those individuals responsible for:
 Operations
 Electronic Medical Records and Scanning
 Accounts Receivable
 Charge Entry
 Quality Control
 Coding and Documentations
 Contract compliance
• Facilitate communications and teamwork among various organizational functions in RCM.
• Works with operations providing training, policies and procedures and support to ensure optional efficiency and cost containment initiatives for the RCM
• Facilitate continual education and training for RCM involving:
 Proper coding and documentation
 Billing policies and procedures for all carriers in all states including government carriers
 HIPAA
 Compliance – Fraud and Abuse
• Provides Reports indicating the key financial and productivity metrics including but not limited to:
 Denial Reports
 Actual Payments from 3rd Party Payors compared vs. Contracted Rates
 Net Collections
 Gross Collections
 Aging Accounts Receivable
 Staff productivity benchmarks
• Work with Finance Department to ascertain budgeted revenue on a monthly basis based on contracted rates and expected collection percentage. Establish benchmarks of productivity and effectiveness for all functions of the RCM (utilizing resources including but not limited to comparison with similar entities, MGMA, HFMA benchmarks).
• Review audits of work performed by all functions of RCM.
• Present statistics of productivity and efficiency to Executive staff providing comparisons to benchmarks.
• Oversee the appraisals, formal and informal, of all individuals in the RCM.
• Oversee Records including but not limited to:
 Training and mentorship of Supervisor
 Tracking and trending of productivity and quality
 Scanning of all records from sites and satellite operations
 Timely entry of records into scanning system from the date of service
 Ensure all charts are reconciled with cases performed by end of month
 Providing missing or illegible information to Operations for accurate charge entry
• Oversee Charge Entry including but not limited to:
 Training and mentorship of Supervisor
 Tracking and trending of productivity and quality
 Timely entry of charges between date of service and date of entry
 Apportioning work volume
 Utilizing contract management systems and procedures
• Oversee Accounts Receivable including but not limited to:
 Training and mentorship of Supervisor
 Tracking and trending of productivity and quality
 Tracking of AR and collections tracking aberrations
 Instituting best practices
• Oversee RCM Operations including but not limited to:
 Weekly meetings with management of Operations
 Visits to facilities reviewing best practices for RCM
 Optimization of utilization of CBO
 Ensuring responsiveness of RCM Operations to requests for information and direction
• Oversee IT requirements for RCM including:
 Optimization of the billing, scanning and other IT utilized within RCM
 Ensure utilization of EDI (electronic transfer of claims) is optimized and all issues are logged, tracked and resolved
 Ensure the electronic transfer of claims to all third-party payers in all states are investigated and properly set up and operational
 Ensure contracted rates of all third-party payers and all products with