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Loretto Hospital · 3 weeks ago

Director of Revenue Cycle Management

Chicago, IL

Full-time

Onsite

Lead/Staff, Director/Executive

$125K/yr - $150K/yr

5+ years exp

Loretto Hospital is a safety-net hospital that serves more than 33,000 patients each year from Chicago’s Austin and surrounding communities. The Director of Revenue Cycle is accountable for ensuring the coordination of all revenue cycle functions and activities with the goal of optimizing revenue, directing operations in various areas such as patient scheduling, insurance verification, and financial services.

Health CareHospitalMedicalNon Profit

Responsibilities

Assures revenue cycle activities are coordinated and integrated with other related departments such as patient registration, financial services, case management, utilization review, and health information management

Serves as the primary contact for senior leadership, providing high-level communications and status reporting of revenue cycle metrics, initiatives, opportunities, and timely issues resolution

Develops and implement standards, processes, and controls for all billing activities to ensure a timely, correct and appropriate revenue cycle process

Standardizes revenue cycle reporting to include benchmarks and key performance indicators for departments reporting to revenue cycle

Requests, prepares, and maintains reports on billing, coding, utilization and collection activities

Monitors aged accounts and verifies appropriate collections procedures are being followed

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

Educates management and staff on revenue cycle standards and provides timely feedback of key performance indicators

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

Serves as the subject-matter expert on regulatory, compliance, and legal requirements associated with medical billing and CMS. Ensures compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers

Works with departments to develop and maintain internal controls to target revenue recovery throughout the organization by identifying charge capture, coding, and reimbursement problems, then recommending/implanting solutions

Leads denial management initiatives, collaborating with various clinical and financial team to identify, evaluate and address patterns of rejections, root causes of payment delays and/or payer denials with focus on improving workflows, optimizing revenue collections, and reducing avoidable write-offs

Manages and implements chart audit process

Directs, plans and supervises activities of case managers and discharge planners in following patients throughout the continuum of care to include strategic planning and daily management of operations related to case management for all inpatient units; ensure optimum utilization of resources, service delivery and compliance with external requirements

Participates in multidisciplinary team meetings regarding the planning and implementation of patient care and denials; facilitates communication and problem solving related to discharge planning

Chairs the Revenue Cycle Governance Committee and directs the Charge Master and Denial Management committees. Organizes the agendas, ensures appropriate representation, and bring reports and data to support decision-making

Actively participates in the Utilization Management Committee and provides monthly statistical activity report

Maintains liaison with physicians, hospital administration and ancillary department managers to analyze unit needs, identify problems and effect change as needed to improve services

Qualification

Revenue cycle managementHospital billing practicesMeditechEpicMicrosoft OfficeAnalytical skillsCustomer service skillsPublic speakingCommunication skillsProblem-solving skills

Required

Bachelor's degree in Accounting or other related field, or in lieu of degree, two years of experience for each year of college required

Previous management or supervisory experience

In depth knowledge of hospital, charging and billing practices normally acquired through 5 or more years' experience in a department that performs revenue cycle functions (e.g., patient accounts, registration, coding, etc.) in order to understand revenue cycle issues

Working knowledge of Meditech, Epic or other similar electronic health application(s)

Excellent communication and customer service skills

Excellent public speaking and presentation skills

Proficient in Microsoft Office applications, including strong Excel skills

Excellent analytical and problem-solving skills