Job Description

GENERAL STATEMENT OF DUTIES

Revenue Optimization – National executive oversight, of developing, planning, organizing, and implementing current and future strategies to bill customers, process payments, minimize bad debt, improve cash flow, optimize receivables and manage the overall health of the company’s receivables. Executive oversight to improve processes as they relate to revenue cycle functions which include but are not limited to, front office policies and processes, billing, collections, accounts receivables, and financial planning for patients. This leader will work with the assigned staff and specialty hospital, ASC, and clinic business offices on revenue cycle performance to meet strategic goals. This position will create and/or update written guidelines, policies, and procedures in accordance with an implementation of all work processes as a result of ongoing analysis.

ESSENTIAL FUNCTIONS

Planning

• Developing strategic plans and programs for the Revenue Cycle team and ensuring objectives of the team are properly defined and established.
• Developing policies and guidelines and implementing procedures while ensuring consistent company-wide implementation.
• Ensuring that operating expenses are well within the prescribed limits of budget plans and fiscal guidelines.
• Providing projections and reports as required, for the development and management of budgets; producing and analyzing monthly reports that assist in the forecast process.
• Monitoring timeliness and effectiveness of department activities, ensuring that outstanding patient accounts and accounts receivables are within the agreed-upon limit and that bad debt is within budgeted target.
• Monitoring the effectiveness of collection efforts and maintain insurance billings that are current within the established time frame specified in the department policy.
• Enhancing workflow processes throughout the revenue cycle to assist in achieving consistency in maintaining the critical success factors.
• Ensuring effectiveness in maximizing utilization of both asset and people resources.
• Leading integration efforts when entering new markets and/or adding new business units within existing markets.
• Establishing effective communication strategies for providers in all markets to gain understanding of all revenue optimization processes in place.

Controlling

• Ensuring that Revenue Cycle processes are controlled through Performance Metrics and Standards. National benchmarking is paramount to measure ongoing performance.
• Reviewing the performance of the team regularly to ensure metrics and standards are well within pre-established goals and objectives.
• Consolidating performance standard reports to monitor the progress of initiatives.

Leading

• Designing and develop the appropriate organizational structure for the Revenue Cycle team and staff accordingly.
• Conducting regular meetings with the team, to ensure the implementation of Revenue Cycle plans, programs, and projects strictly adhering to prescribed deadlines and schedules.
• Implementing a “Performance Improvement Program” to best manage and mentor staff, where applicable
• Developing team performance measures and review and evaluate team performance regularly and during the annual performance review period.
• Developing training programs that are relevant to the continuous development of staff.

Managing Patient Service Functions

• Managing the patient services and billing staff in handling patient relations.
• Ensuring resolution of complex patient complaints and issues by sharing company policies and guidelines as well as those involving compliance issues with State and Federal regulations.
• Developing plans and programs in conjunction with CORE leaders to monitor patient relations thru the conduct of regular patient satisfaction surveys.

Managing State and Federal Regulations

• Ensuring that HIPAA Notices of Privacy Practices are on display, if applicable.
• Ensuring that records are stored securely and handled in compliance with HIPPA privacy and security regulations.

EDUCATION

• Bachelor's Degree in Healthcare Administration, Business or another related field or equivalent required.
• Master’s Degree preferred.

EXPERIENCE

• Minimum 10 years of experience in revenue cycle management and, ideally 5+ years in hands-on revenue cycle leadership at a VP level or higher.
• 10 or more years of increasing executive responsibility with proven results; Significant responsibility and experience in large, multispecialty physician practices across multiple locations.

KNOWLEDGE

• Deep knowledge of revenue cycle management in specialty or private practice billing and scheduling.
• Strong knowledge of patient access and scheduling policies including best practices and standards.
• Demonstrated understanding of healthcare, market dynamics, trends, and impact on physician practice management and ability to compete and grow.
• Strong understanding of workflow management, service line development, and operationalization.
• Strong background in financial management with knowledge of complex reimbursement structures and governmental regulations to the billing processes.
• Successful track record developing, coaching, and mentoring high-performing teams in a technology-enabled business across multiple locations.
• Superior judgment, negotiation, and decision-making skills with a high level of professional integrity.

SKILLS

• Strong analytical, problem solving and critical thinking skills to interpret strategic vision into an operational model.
• Strong skills utilizing practice management billing and scheduling systems.
• Strong interpersonal skills.
• Strong written and verbal communication skills.
• Excellent presentation skills, comfortable facilitating discussion amid diverse perspectives.

ABILITIES

• Ability to encourage motivation, innovation, and high performance.
• Ability to exercise sound judgment and make decisions based on accurate and timely analyses.
• Microsoft Office products including Word, Excel, and Outlook and experience using practice management billing and scheduling systems.

ENVIRONMENTAL WORKING CONDITIONS

• Normal office environment.
• Some travel related to evaluating and managing HOPCo managed clients.

PHYSICAL/MENTAL DEMANDS

• Requires sitting and standing associated with a normal office environment.
• Some bending and stretching are required.
• Manual dexterity using a calculator and computer keyboard.

ORGANIZATIONAL REQUIREMENTS

• HOPCo Mission, Vision, and Values must be read and signed.

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve.