SUMMARY:
We are currently seeking a Middle Revenue Cycle Director to join our Revenue Management. This full-time role will primarily work hybrid (you will need to have an onsite presence).
Purpose of this position: Develops Health Information Management, Documentation Integrity, Clinical Documentation Improvement, Revenue Integrity and Coding strategies. Directs hospital billing coding, professional billing coding, health information management operations, revenue integrity (charge master, fee schedules, charge reconciliation and training, pricing) clinical documentation improvement program, and documentation integrity. In addition, working with the patient access services, CDM, patient financial services and the entire organization to improve clinical documentation and charge capture across the organization.
RESPONSIBILITIES:
- Directs Health Information Management Operations, Hospital Billing Coding, Professional Billing Coding, Clinical Documentation Improvement Program, and Documentation Integrity.
- Leads and is accountable for organization projects affecting areas of responsibility.
- Provides direction for Release of Information, Transcription, and other external service agreements.
- Provides direction for Revenue Integrity (charge master, fee schedules, charge reconciliation and training, pricing).
- Develops and implements policies and procedures that guide or support service, assesses and improves department performance, and ensures orientation and continuing education of department staff.
- Develops specific objectives, budgets, and performance standards for each area of responsibility. Actively seeks ways to control costs without compromising patient safety, quality of care of services delivered. This person may recommend resources needed by the department and may participate in the selection of outside services.
- Actively participate in advising HCMC leadership on methods to optimize HCMC's use of Epic.
- Responsible for compliance with all applicable regulations including Hospital Attorney General Agreement, State of Minnesota Department of Revenue-Revenue Recapture, and HCMC Admissions and Treatment Policy.
- Improve Revenue Cycle performance, efficiencies, transparency, and employee engagement through Lean Management methods including Visual Management Systems and incorporate metrics driven outcomes through revenue cycle.
- Work with Public Relations, Patient Experience, and other HCMC departments to maintain and enhance community and patient communication related to HCMC charity care, billing and collection procedures, and methods for patients to access revenue cycle resources.
- Collaborate with the Assistant Medical Director of Documentation Quality and Associate Medical Director of Clinical Documentation Improvement to improve and optimize the organization's documentation quality standards and practices.
QUALIFICATIONS:
Minimum Qualifications:
- Bachelors degree in Health Information Administration/Medical Record Administration. Education program must be accredited by the American Health Information Management Association (AHIMA).
- 7-10 years of progressive management experience in a healthcare operations environment is required.
- 5-7 years' experience managing Health Information Management and Coding.
-OR-
- An approved equivalent combination of education and experience.
Preferred Qualifications:
- Epic Revenue Cycle Management Systems experience.
- Master's degree in Health Information or Health Care Management is desirable.
Knowledge/ Skills/ Abilities:
- Demonstrates a working knowledge of word processing and spreadsheets, HIPAA regulations, The Joint Commission standards, and clinical information systems.
- Must have extensive and demonstrated expertise in CPT-4, HCPCS, and ICD-(-CM coding.
- Must have a thorough knowledge of medical terminology, anatomy and physiology and ability to interpret physician's medical documentation.
- Must have in-depth understanding of third party reimbursement and coverage policies.
- Proven, successful, progressively responsible leadership, management and execution experience.
- Exhibits a strong presence of command.
- Ability to develop and implement process improvements, preferably using Lean or Six Sigma methodologies.
License/Certifications:
- Certification as a Registered Health Information Administrator (RHIA).
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