Healthcare experience required.
KNOWLEDGE, SKILLS AND ABILITIES:
- Understands commercial insurance payers and provides guidance on maximizing reimbursement
- Establishes procedures to ensure maximum efficiency and collection of accounts receivable and ensures adherence to standard operating procedures
- Ability to forge effective working relationships with other members of the leadership team, and with direct reports.
- Reports reimbursement trends and global concerns to senior management to ensure corrective actions and mitigation of future occurrences.
- Demonstrates experience in diagnosing, evaluating, and developing corrective action plans for problems within revenue cycle operations.
- Ability to effectively influence change.
- Knowledge of all functional areas of the revenue cycle, including charge capture, productivity review, health information management, information systems.
- Ability to establish and utilize performance measures throughout the revenue cycle process.
- Ability to communicate effectively in writing and verbally.
- Leads/drives effort to collect commercial insurance claims through effective verbal and written communications with payers.
- Utilizes performance measures to assess the functional areas that impact the revenue cycle.
- Educates functional areas as to their impact on revenue cycle performance measures.
- Leads process reviews to improve quality, efficiency, effectiveness of revenue cycle activities.
- Reviews departmental performance to ensure efficient, proper, complete collection of earned revenues.
- Provides departmental direction and supervision, including a vision for future direction of the department.
- Must maintain a high degree of confidentiality at all times due to access to sensitive information.
- Maximizes use of technology to improve data quality, timely collections, consistency of service and competitive advantage.
- Develops and implements policies and procedures to improve the functionality of billing and collections functions.
- Leads the process to systematically evaluate, monitor, and report on regulatory compliance related to the revenue cycle.
- Establishes and utilizes an account denial process to monitor, and minimize payer denials.
- Coordinates with all audits/auditors the activities related to the department.
- Completes timely staff appraisals.