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Centinela Hospital Medical Center · 2 months ago

Corporate Director, Billing Optimization

US-TX-Farmers Branch

Full-time

Onsite

Director/Executive

8+ years exp

Prime Healthcare is an award-winning health system headquartered in Ontario, California. The Corporate Director of Billing Optimization is responsible for the strategy, management and implementation of the Enterprise Billing Program, focusing on optimizing revenue cycle management and improving billing operations metrics.

Health Care

Responsibilities

The Corporate Director of Billing Optimization is responsible for the strategy, management and implementation of the Enterprise Billing Program, actively owning the portfolio across Revenue Cycle Management and drive optimization and improved metrics across the clearing houses

The Director will partner with revenue cycle and business office leaders across all levels of the organization to execute goals and plans of reach / exceeding key performance indicators (KPI) relating to billing operations, which include but are not limited to: 837 files, billing edits, clean claim rate standards, billing errors and trends, as well as claim rejections and trends

Through strategy development, aligning the annual initiatives and collaboration, the Director will lead improvement efforts through execution of business objectives and strategic initiatives

The Director will provide issue resolution, develop and implement standard operating procedures (SOP) when needed, participate in go-live implementations to ensure successful transition, as well as provide effective communication and stakeholder management at all times

The Director is accountable to the VP of Outsourcing and Strategic Initiatives for timely reports and updates relating to key initiatives, delivering successfully on timelines, as well as effective management of staff and delivery of appropriate productivity and quality parameters if the Director has direct reports

Qualification

Revenue Cycle ManagementBilling IntegrityEPIC ImplementationAnalytical SkillsStakeholder ManagementRelationship ManagementProcess Change ExecutionManagement ExperienceIT Revenue Cycle ToolsBridge Routine ManagementCommunication SkillsProblem-Solving SkillsCollaborative Skills

Required

Bachelor's degree (B.A.); a minimum of 8-10 years related experience and/or training; or equivalent combination of education and experience

Five (5) years of experience with acute hospital/ facility revenue cycle setting

Prior working experience within Supervisory/ Management capacity, specifically with Billing Integrity, Revenue Integrity, and Billing Process, includes managing the billing for all payors, includes managing bridge routines

Prior experience in implementing clearing houses and preferably rollout of EPIC program in a large hospital setting

Ability to envision and execute; process and policy changes, change in corporate culture, alignment between enterprise strategy and individual business channel needs

Proven ability to effectively interact with key stakeholders, hospital leadership and other team members, while maintaining standard of professional business service

Strong communication and relationship management skills

Ability to form collaborative working relationships

Strong analytical and problem-solving skills. Ability to review weekly, monthly metrics – leading and lagging KPIs and own action plans. Proven ability to make logical correlations between data points to determine if analysis is accurate

Ability to envision and execute; process and policy changes, change in corporate culture, alignment between enterprise strategy and individual business channel needs

Preferred

Proficiency with IT hospital revenue cycle tools like CHC / Relay Assurance (also known as ePremis, now part of Optum), EPIC, Meditech

Advanced knowledge and management of bridge routine files – writing and modifying, CCI edits, 835, EFT, ERA, and claim error trends across multiple payor base and across states

Meditech and EPIC: basic navigation of systems as a minimum