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Meharry Medical College · 3 weeks ago

Director, Revenue Cycle and Operations

Nashville Metro

Full-time

Onsite

Lead/Staff, Director/Executive

5+ years exp

Meharry Medical College is a healthcare institution seeking a Director of Revenue Cycle and Operations. The Director will oversee all business aspects of the practice, including revenue cycle and clinical operations, and will be responsible for creating and executing policies to ensure compliance and optimize revenue.

EducationHigher EducationUniversities

Diversity & Inclusion

Responsibilities

Accountable for overseeing, directing, coordinating, and regulating all daily operations related to the physicians' billing, accounts receivable management, and clinical functions for the Meharry Medical Group and Total Health

Reviews and offers guidance to the contracted billing vendor or central billing office to guarantee that all provider billings are processed promptly and accurately, and that all accounts receivable are pursued in a similar fashion

Establishes accounts receivable policies and practices aimed at billing and collecting patient accounts and other revenue sources in a timely manner, reducing uncollectible accounts, maximizing cash flow, and preserving community goodwill

Develops, implements, and maintains objectives, procedures, and standards to optimize revenue; analyzes reimbursement and payment regulations for physician services to ensure compliance with HMO contracts and HCFA guidelines for teaching physicians

Continuously evaluates the work methods and systems impacting physician billing, offers timely and effective recommendations for workflow improvement, and executes approved modifications

Cultivates effective communication channels with physicians through ongoing committee and department chair meetings, a policy and procedure manual, and monthly newsletters

Delivers revenue cycle and financial reporting packages to the Senior Vice President of Health Affairs, Associate Dean of Business and Finance, School of Medicine, and other members of the Meharry Medical Group clinical leadership team

Collaborates closely with the Associate Dean of Business and Finance of the School of Medicine on quarterly Board Reports

Supervises educational training for physicians and their staff regarding the appropriateness of procedural and diagnostic coding

Ensures compliance with all legal and regulatory requirements by staying informed of changes and implementing necessary controls and/or programs to meet these requirements

Guarantees that the flow of data, documents, and information critical to operations is efficiently organized, coordinated, and adheres to city, state, and federal regulations. Compiles reports and conducts audits as needed

Prepares, reviews, and submits the annual operating budget; monitors and ensures compliance with

Assists faculty in preparing for managed care and risk-based contracting by providing education and developing related policies and procedures in collaboration with the leadership of Meharry Medical Group

Aids the Senior Vice President of Health Affairs, medical directors, MMG leadership, and faculty representatives in the creation and oversight of managed care and risk-based contracts

Offers support to the Senior Vice President of Health Affairs, Department Chairpersons, and Committees in formulating operational processes for the execution of clinical/medical policies, which include practice and referral guidelines, peer review standards, utilization review policies, and quality assurance initiatives

Collaborates with the Senior Vice President of Health Affairs to establish a working relationship with senior management staff at Metro General Hospital and other hospital systems to facilitate and coordinate billing, medical records, compliance, and physician-related issues concerning patient care and services

Ensures the efficient operation of all clinical front office activities, including the call center, registration, front desk exit processing, front office operations, billing, coding, medical records, and compliance

Oversees the implementation of training programs focused on customer/patient satisfaction, eCW utilization, coding, medical record documentation, and all pertinent policies and procedures

Engages in negotiations with insurance companies, external vendors, and others to guarantee that MMC secures the most favorable reimbursement/pricing on relevant contracts

Provides senior leadership with monthly reports (and on a need-to-know basis) that detail the financial, compliance, and programmatic status of relevant programs and services

Takes the initiative on additional responsibilities such as ensuring HIPAA compliance

Develops, implements, and sustains an operational presence that is prompt in addressing all provider inquiries, operational management challenges, and recommendations

Sets specific goals and objectives in accordance with the requirements communicated by Meharry Medical Group and the Senior Vice President of Health Affairs

Keeps abreast of current medical trends and advancements in physician practice management and managed care; fosters relationships with counterparts in affiliated organizations to enhance quality, financial performance, information systems, and operational management

Ensures open communication and information exchange through regularly scheduled individual and group staff meetings, committee meetings, and faculty meetings

Conducts necessary reviews, analyses, and evaluations to confirm that operations are fulfilling the needs and requirements of the physician, medical college, hospital, and contracted health plans

Guarantees that all divisional directors, managers, clinic staff, and faculty are well-informed about significant policies and procedures, revenue cycle, medical records, and the outcomes of actual operations. Maintains close communication with the Associate Dean of Business and Finance for the School of Medicine, Senior Vice President of Health Affairs, Medical Director of Meharry Medical Group, and relevant leadership at Meharry Medical College

Engages in business operations and personnel hiring, conducts written performance evaluations, and assists in resolving complex employee relations issues

Develops, implements, and maintains written job descriptions that include standards for evaluating each job classification, and performs written assessments of employee performance based on responsibilities and performance targets outlined in the job description

Interviews candidates and recommends new hires; prioritizes schedules; formulates corrective action plans and disciplines in accordance with the organization's established rules, policies, and procedures

Approves requisitions for supplies, equipment, and other items essential for proper operations

Performs related duties and other tasks as assigned

Ensures that employee turnover is kept to a minimum

Implements state and federal regulations on clinic records management

Arranges for HIPAA, OSHA and risk seminars in conjunction with Human Resources

Plans, organizes, directs, monitors, and supervises the daily workflow of the Medical Coding Department to ensure the accurate assignment of ICD·9 ICD-10, CPT-4 and physician charges and month end closing standards for the facilities are met, and that staff productivity is maintained according to established standards

Ensures assigned staff is meeting expected quality and quantity levels in the application of Team Health Billing and Coding Guidelines, Coding work file, DMS, NEIC edits, Provider reports, etc

Qualification

Healthcare managementRevenue cycle managementFinancial managementICD-10ICD-9Certified Revenue Cycle RepresentativeLeadershipAnalytical skillsTeam developmentChange managementEthicsNegotiation skillsCommunication skillsIntegrity

Required

Minimum of 5 years' experience in health care management such as but not limited to clinic management, patient management, accounts receivables and payables, and coding

Bachelor's degree in health care administration, business or another related field

Advanced knowledge of ICD-9

Working knowledge of ICD-10

Strong background in financial management and knowledgeable of federal and state laws and requirements relating to healthcare management

Strong managerial competencies in the areas of leadership and team development, managerial coaching and mentoring and situational assessment skills and with proven track record in building and developing high performing teams

A change agent and capable of guiding the organization in initiating various change management initiatives with the view of leading and guiding the organization towards the future

Strong managerial acumen in setting corporate directions and aligning strategic goals around business plans

Superior judgment, negotiation and decision-making skills

Strong ethics and a high level of personal and professional integrity

Strong analytical skills and adept in interpreting strategic vision into an operational model

An effective communicator at all levels in the organization, with strong oral, written and persuasive skills

Ability to generate financial reports for executive management

Certified Revenue Cycle Representative Certification