Under general supervision of the Chief Financial Officer, the Director of Revenue Cycle aids in key initiatives that support the ongoing pattern of progressing financial management at HMH. Provides leadership and oversight for Revenue Cycle departments. Works closely with providers and leadership to ensure accurate charge entry, timely claim submission, and denial prevention. Creates and implements policies and procedures that are compliant with applicable regulations. Provides leadership for house-wide charge capture, coding, and accounts receivable. Maximizes cash collections consistent with regulatory requirements and in compliance with applicable laws to achieve the financial goals of the organization.
Essential Job Functions
Every effort has been made to make this job description as complete as possible. However, it in no way states or implies that these are the only duties the incumbent will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or is a logical assignment to the position.
Ensures integration of the department(s) into the primary functions of the organization. Creates a collaborative, productive work environment through positive relationships with senior leadership, other directors, physicians, employees, patients/families and the community.
Plans, directs and supervises all aspects of the Revenue Cycle, and achieves established performance goals
Assumes shared responsibility for financial applications in all areas of hospital
Works directly with CFO and executive team to develop data analysis of issues and questions that lead to solutions
Aids in revenue enhancement by performing cost analysis of services lines, contract analysis, and review of billing practices within departments, hospital, and clinics
Performs payer analysis (Logging, Modeling, and Cashiering)
Oversees payment resolution (Clinical Appeals, and Payment Discrepancies)
Understands and Implements Bad Debt and Charity policies
Performs hospital financial analysis, including components of Net Revenue, Charity and Bad Debt.
Ensures compliance with all regulatory and internal audit requirements
Develops and implements appropriate policies and procedures
Plans and provides a sufficient number of qualified and competent staff for the department(s)
Establishes work schedules and assignments to ensure coverage within approved budgetary guidelines
Ensures completion of all employee records including but not limited to: payroll, performance evaluations, competencies, personnel action requests etc
Ensures initial orientation and continuing education opportunities are presented appropriately for all department staff
Coordinates and participates in the development, implementation and evaluation of quality improvement processes for the department. Maintains quality control programs, as appropriate
Participates in the budget planning process. Assists in establishing facility financial goals and objectives
Provides 24-hour accountability of leadership by appropriate delegation, using sound decision making and critical thinking skills
Functions competently in the staff role as necessary
Demonstrates adaptability, problem solving and professional behavior at all times
Participates in continuous Quality Improvement programs
Abides by the HMH Legal Compliance Code of Conduct
Maintains patient confidentiality and appropriate handling of PHI
Maintains a safe work environment and reports safety concerns appropriately
Performs all other related duties as assigned
LATITUDE, CONTACTS/INTERACTIONS
All positions of Huntsville Memorial Hospital are part of an interdisciplinary team, and as such, participate in the care and service delivery process through effective interaction with other team members. Primarily interacts with hospital staff, medical staff, patients, and visitors.
Requirements
QUALIFICATIONS
Education: Bachelor's degree in Finance, Accounting or related field preferred. Experience may be considered in lieu of degree.
Experience: 8-10 years of progressive managerial experience in hospital revenue cycle or finance required.
Required Skills: Excellent analytical, organizational, computer, oral and written communication skills. Strong interpersonal skills, personal work ethic and high degree of personal integrity. Ability to communicate effectively, verbally and in writing. Ability to work independently, prioritize, handle multiple projects and tasks, with attention to detail. Proficient in Microsoft Excel. Detailed oriented in analyzing data.