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Job Description:
Alpine Physicians is a physician-led organization formed with the mission of transforming senior care and restoring the joy of practice to physicians. Alpine helps primary care doctors deliver integrated, coordinated, world-class care to patients, while achieving better compensation and quality of life.
The Vice President, Revenue Cycle Management is responsible for the establishment of the strategic vision, organization, and overall management, as well as administering policies for all Revenue Cycle operations. S/he ensures all financial resources are maximized and optimized, and financial viability is maintained, while continually challenging and transforming Revenue Cycle operations and maintaining a customer-focused operational model. The position is responsible for enhancing and maintaining a properly functioning system centralized patient financial services process. The role promotes a culture of innovation, accountability, and constant improvement throughout Revenue Cycle, while maintaining a dedication to the mission, vision, and values of Alpine Physician Partners.
Duties and Responsibilities:
- Oversee and support the daily operations of all revenue cycle functions, including but not limited to billing, follow-up and collections, cash posting, denial management, and credit balance reviews.
- Establish and maintain departmental policies and procedures. Communicate relevant information to other departments. Establish controls and review mechanisms to ensure procedures are being followed correctly.
- Develop, redesign, and monitor key performance indicators including payer mix, A/R, collection rates, adjustments, bad debt write off, estimated collections, appeal success rates, and other requested parameters.
- Serves as the subject-matter expert on regulatory, compliance, and legal requirements associated with medical billing and CMS. Ensures compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers.
- Develops and maintains internal controls to target revenue recovery throughout the organization by identifying charge capture, coding, and reimbursement problems, then recommending/implementing solutions.
- Oversees the integration of acquired practices’ revenue cycle system into organization’s legacy RCM application.
- Monitor A/R effectively and ensure aging categories are within established goals and national benchmarks and verifies collection processes are being followed.
- Responsible for maximizing the collection of medical services payments and reimbursements from patients, insurance carriers, financial aid, and guarantors.
- In conjunction with operations, reviews and enhances insurance verification, coding review, billing, collection, and payment posting processes for efficiency and best practices; ensure systems are fully functional and maximized and recommend new processes to improve current workflow.
- Monitors daily productions of billings, denials, and appeals.
- Reviews, monitors and recommends updates to the medical practices’ fee schedule to maintain fees at levels that maximize reimbursement.
- Ensures compliance with relevant federal, state, and payor-specific billing requirements.
- Regularly provides upper management with revenue cycle status including reports, metrics, and presentation.
- Direct the selection, supervision and evaluation of staff. Ensure performance evaluations are conducted in a timely manner according to organization policy and initiate disciplinary actions as warranted. Resolve grievances and other sensitive personnel matters.
- Oversee orientation and continuing education for all staff. Ensure mandatory and relevant training is provided to staff in a timely manner.
- Ensure staff is educated on new technology, goals, and contracts.
- Any and all other projects, goals, issues surrounding the revenue cycle, conflicts or concerns as directed or indicated by senior management.
Required Qualifications:
- Thorough knowledge of revenue cycle processes and standards related to billing, collections, and cash posting in a physician / medical group environment. General knowledge of patient registration, finance, and data processing.
- Knowledge of regulatory requirements related to patient accounting, including a solid understanding of Medicare, Medicaid and managed care processes.
- A minimum of 10 years of experience of billing and collection activities in a health care / physician organization setting, of which at least 5 of which has been in a senior managerial capacity.
- Ability to work and communicate effectively with a diverse group of people including other department managers, staff, physicians, patients, and the public.
- Ability to read, analyze and interpret financial reports, contracts, and other legal documents.
- Outstanding ability to work independently to achieve results. Often, there is no precedent for and little help in carrying out assigned tasks. Must originate, plan, adapt and invent to accomplish tasks.
- Ability to set and maintain priorities when dealing with multiple demands and interruptions.
- Strong analytical and problem-solving skills.
- Background in system integrations in conversions in an acquisitive, constantly changing environment.
- Dedication to the development of others and willingness to coach and mentor people as necessary to promote their personal and professional growth.
- Excellent customer service and communication skills.
- Intermediate computer skills including email, word processing and spreadsheets. Experience in working with numerous billing and collection systems, and ability to identify strengths and weakness of systems and related processes.
If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!
Salary Range:
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