Develops dashboards and processes for continuous management and analysis of revenue cycle functions. Develops and proposes new or changing components of the revenue integrity program, to maximize revenues and increase efficiencies.
- Responsible to achieve revenue and collection performance targets that are complex and require management of functions at various levels. Monitors all day to day revenue cycle activities for the department and collaborating closely with involved parties to ensure smooth processing. Coordinates regular billing management meetings to discuss billing trends, review individualized custom reports, system-generated reports and to discuss billing-related issues.
|
15 |
Analyzes highly-complex financial data and identifies trends in revenue cycle functions and integration of operations. Delivers comprehensive reports and presentations to leadership, to include proposals and solutions to maximize revenues.
- Responsible for the comprehensive management of billing, collections and accounts receivable operations. Analyzes accounts receivable reports to proactively respond to potential problem areas and to determine performance levels. Monitors and takes action expediently on any adverse trends to avoid potential revenue shortfall.
|
20 |
|
Works with Information Technology to define needs and system enhancements. Design models, using input from departments, operational experience, and best practice research. Statistical and financial results in revenue cycle departments and on the workflows and system efficiencies of revenue cycle functions.
|
5 |
Leads and/or monitors progress and priorities on projects. Collaborates with departments across the system to assimilate and define needs, develop goals and metrics, and define system requirements and capabilities.
- Analyzes compliance reports by physician and division including financial impact and attends physician compliance meetings to provide education and assistance. Works closely with physicians to educate and assist them in achieving their WRVU targets. Works with controller to produce physician time study. Educates physicians on proper method for completing the form, and ensures that reports are submitted timely.
|
10 |
Serves as a technical leader and resource in evaluating revenue cycle workflows to propose improvements in efficiencies and timeliness. Provides guidance and expertise in the development of highly-complex workflow improvements to integrate practices in all revenue cycle areas and maximize revenues.
- Audit charges for appropriate CPT and ICD-10 coding. Performs analysis of trends on charge capture and coding issues.
|
10 |
|
Recommends and implements new processes and systems to improve charge integrity, reconciliation and charge linkages from ancillary charging systems for the medical center / health system.
|
10 |
Develops and delivers training to patient financial services units on revenue cycle systems, processes and procedures. Patient finance areas include registration, insurance verification, financial counseling and authorization processes.
- Responsible for defining and educating faculty on principles of appropriate documentation. Provides education and assistance to physicians and staff on all aspects of coding and billing.
|
5 |
Develops and implements changes to systems, policies and procedures to maintain currency in government regulations, reimbursement issues and other matters having potential financial impact.
- Analyze and communicates the impact of these changes. Reviews and analyzes information received from auditing entities, including internal audit, CMS and compliance office.
|
5 |
|
Develops sound coding procedures based on documented medical necessity to avoid legal reprisals resulting from billing audits. Focuses on precise coding practices to reduce contested or denied claims and to improve the reimbursement turnaround time.
|
10 |
|
Functions as a member of the administrative leadership team for the department and participates in monthly leadership meetings providing monthly updates on issues related to billing, coding and reimbursement. Participates in departmental budgeting process by estimating faculty performance levels and clinical revenue. Fosters a customer service orientation in all internal and external interactions. Participates in development of measurable program objectives with strategies for obtaining success. Establishes and maintains collaborative communications throughout the department and billing for an effective and successful billing organization.
|
10 |
