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ECU Health · 1 day ago

Executive Director, Revenue Cycle

Greenville, NC

Full-time

Hybrid

Director/Executive

10+ years exp

ECU Health is a mission-driven academic health care system serving over 1.4 million people in eastern North Carolina. The Executive Director will oversee Business Office functions related to billing, collections, and compliance, while driving strategic revenue management initiatives and collaborating with various stakeholders to improve overall performance in the revenue cycle.

Hospital & Health Care

Responsibilities

Developing and recommending potential organizational policy changes to the Vice President of Revenue Cycle Management; then once committee approved following through with implementation

Assist with the development of budgets and monitoring of department operations to achieve goals within budget

Maintains extensive knowledge of revenue cycle and regulatory requirements associated with governmental, managed care, and commercial payers

Oversees account statuses based on Days on AR, DNFB, CFB and communicate to billing management expectations and accountability

Serves as the subject-matter expert on regulatory, compliance, and legal requirements associated with medical billing and CMS

In conjunction with operations, reviews and enhances insurance verification, coding review, billing, and collection processes for efficiency and best practices; ensure systems are fully functional and maximized and recommend new processes to improve current workflow

Reviews, monitors, and recommends updates to the fee schedule to maintain fees at levels that maximize reimbursement

Regularly interacts with vendors while monitoring performance and contractual obligation. Works with the management team to establish A/R and industry performance metrics and monitoring and reporting on performance against established metrics

Review performance data that includes financial and activity reports and spreadsheets to monitor and measure departmental productivity, goal, achievement, and overall effectiveness

Attends monthly leadership meetings and/or other meetings as directed. Disseminates information from Vice President to department managers, supervisors, and staff. Schedules and leads monthly team meetings

Works in conjunction with the Vice President on provider concerns and questions around wRVUs, coding, and billing

Partner with Finance to analyze reimbursement impacts on financial performance and support budgeting processes

Stay current on federal and state regulations related to reimbursement and billing for durable medical equipment

Work closely with legal and compliance teams to ensure adherence to all applicable laws and guidelines

Establishes objectives to accomplish physician practice and hospital service line goals, as applicable

Identifies opportunities and works toward cost reduction

Improve in days to bill, days in accounts receivable, days of cash on hand, bad debt expense, timeliness in charge capture, avoidable losses

Deploy a comprehensive management toolkit and report card metrics to enhance performance in key indicators

Interviews, hires, trains, evaluates and develops subordinate management staff in accordance with defined policies and objectives

Sets standards for conduct of work as well as for the required performance and supervises compliance with such standards

Accountable for and models a culture of excellence for the department

Provide feedback to management team regarding potential changes or enhancements to improve staff performance and ensure work quality has a positive impact on the revenue cycle

Ensures that staff receives information by developing and implementing a communication plan with staff input

Participates in leadership growth and development

Qualification

Revenue Cycle LeadershipEpic SystemsMedical Billing KnowledgeCPT CodingICD-10 CodingClaims SubmissionRegulatory ComplianceLeadership SkillsCommunication SkillsTeam Management

Required

Bachelor's Degree or higher is required

10 years of Revenue Cycle leadership experience is required

Minimum of 8 years' experience in large academic/community group practice, and multi-hospital system with emphasis on back-office functions (claims submission, A/R follow-up, customer service, and cash services)

Solid understanding of Epic and EPIC business tools, to include use of Resolute, Prelude, Cadence and MyChart

Thorough understanding of EDI standards for electronic claims submission

Must have strong knowledge of medical insurance billing and collections, CPT, ICD-10, and HCPCS coding