Director Revenue Cycle (1621) Juneau, Alaska

Salary: Neotiable + Relocation

 

 

Position Title

 

 

Director Revenue Cycle (000)

Department(s)

Patient Access Services (PAS), Patient Financial Services (PFS), and Health Information Management (HIM)

Reports to

Chief Financial Officer (CFO)

Population Served

Patients, families, visitors and volunteers, co-workers and physicians and outside vendors and other agencies.

Supervises

Patient Access Services Representatives/Specialists Insurance Verification, Communication, Chart Audit Representative/specialists.  Patient Financial Services Supervisor, Collection Supervisor.  Health Information Management staff.

CARE Values

C ourtesy – We act in a positive, professional and considerate manner, recognizing the impact of our actions on the care of our patients and the creation of a supportive work environment.

A ccountability – We take responsibility for our actions and their collective outcomes; working as an effective, committed and cooperative team.

R espect – We treat everyone with fairness and dignity by honoring diversity and promoting an atmosphere of trust and cooperation.  We listen to others, valuing their skills, ideas and opinions.

E xcellence – We choose to do our best and work with a commitment to continuous improvement.  We provide high quality, professional healthcare to meet the changing needs of our community and region.

 

JOB DESCRIPTION

Manages the day-to-day operations of the Patient Access Services department and carrying out hospital policy regarding the functions this department is responsible for.  Oversees all registrations/admissions, insurance verification, switchboard, some cashiering and other related areas. 

Manages general business functions of the Patient Financial Services department relating to accounts receivable and is responsible for optimizing cash collections within the rules and regulations governing health care accounts receivable. 

Plans, designs, develops and manages the medical record system of the Health Information Management department, including administrative and clinical data, and provide services that meet medical, administrative, legal, ethical, regulatory and hospital requirements. Responsible for confidentiality of medical records.

Responsible for hiring, training, evaluation, scheduling and supervision of Patient Access Services staff, Patient Financial Services staff, and Health Information Management staff reporting to this position and approving all staff hires in these departments.  Maintains charge master, computer module dictionaries and certain MIS dictionaries as assigned. Acts as chargemaster coordinator.  Participates in other hospital committees and teams as appropriate. Performs other duties as assigned.

Essential Functions (included but are not limited to the following):

PAS

  1. Hires, trains, supervise, evaluates, staffs and schedules Patient Access Services staff which include representatives/specialists, communication, insurance verification and chart audit positions. Responsible for the overall organization of department staff.  Demonstrates ability to perform all Patient Access Services functions and does so when necessary.
  2. Oversees the day-to-day operations and functionality of the Patient Access Services department, the flow and storage of information and documents.
  3. Participates in determining Patient Access Services department objectives, policies and procedures and for maintaining the P&P manual with updates and revisions; implements, provides feedback of, and participates in determining the effectiveness of these objectives, policies and procedures.  Emphasizes teamwork and encourages the CQI process where applicable.
  4.  Oversees financial chart review at the time of admission and discharge, identifying, obtaining, and documenting incomplete information, including pre-authorizations, admission notifications, and demographic information.
  5. Demonstrates knowledge, understanding and usage of the computer system to perform all Patient Access Services functions and limited Patient Financial Services functions. Acts as the ADM module coordinator for Bartlett. 
  6. Abides by billing regulations for all payers; oversees all registrations, admissions and insurance verification, following the correct regulations/guidelines for the specific payer.
  7. Prepares and manages the budget for the Patient Access Services department.
  8. Oversees the preparation and distribution of the hospital-wide on-call schedule and for coordinating/communicating changes in a timely manner to those affected.
  9. Oversees the day-to-day registration/check-out of Bartlett House rooms, collection of guest fees and notification of cleaning needed; maintains the daily registration log and petty cash for BH.
  10. Handles complaints; researches, audits and follows up when necessary to resolve patient issues.
  11. Oversees cash collections and the handling of the petty cash located in the Patient Access Services department.
  12. Organizes and holds monthly staff meetings.
  13. Assures confidentiality for all patient/customer information as per Personnel Policy 10.10.
  14. Supports Bartlett Regional Hospital’s strong commitment to the highest standards of business and professional ethics.  Provides services in compliance with all State and Federal laws governing the Hospital’s operations.

PFS

  1. Hires, trains, supervises, evaluates and assists the PFS Supervisor and the Collections Supervisor.  Responsible for oversight of Supervisors’ duties and responsibilities.
  2. Establishes department objectives, policies and procedures and evaluates effectiveness.  Emphasizes teamwork and encourages the CQI process where applicable.  Implements procedures and trains as needed.
  3. Follows-up on Medicare and Medicare replacement plan accounts, including research, patient contact, obtaining reviews, rebilling, no-pay or balance after billing and appeals. 
  4. Responsible for Medicare credit balance accounts, refunding Medicare when necessary and submitting quarterly credit balance reports to Medicare Intermediary.  Responsible for MSP education.
  5. Reviews and works financial reports at least weekly (such as discharged, unbilled accounts, 72 hour Medicare accounts, charges entered on pre-registered accounts, etc.)
  6. Reviews and makes determination on Community Funded Care Program and Sliding Fee applications.
  7. Reviews and enters refund requests for patient accounts.
  8. Prepares and manages budgets for Patient Financial Services.
  9. Keeps current on all regulatory changes regarding accounts receivable and communicates and implements changes and training when necessary.  Ensures compliance within department with all CMS regulations and audit requirements and is member of Compliance Committee.
  10. As part of the Collection Committee, reviews accounts from the hospital, chemical dependency and physician offices on a monthly basis for collection action (e.g. collection agency, litigation, etc.)
  11. Maintains hospital’s charge master, including price changes/edits, new charge codes, description changes, CPT/HCPCS applications, annual price increases and revenue code applications.  Works with managers to ensure their charges and CPT/HCPCS are correct.
  12. Oversees administration and maintenance of electronic billing and remittance software.
  13. Coordinates testing of updates to relevant computer module and communicates changes to personnel and trains when necessary.
  14. Oversees daily processing and month end closing of systems.  Performs system purges and month end archiving of revenue reports.
  15. Maintains dictionaries ensuring that bills, statements, reports, reminders etc. print correctly and accurately and that changes and new entries flow correctly.
  16. Maintains certain MIS dictionaries, such as the insurance dictionary ensuring that the changes and/or creation of new entries flow through and are entered on all other coordinating dictionaries.
  17. Responds to audit requests by insurance companies, and participates as needed in audits and surveys performed by regulatory agencies.  Member of RAC committee.
  18. Provides patient account/financial reports as requested by management and other managers.
  19. Assures confidentiality for all patient/customer information as per Personnel Policy 10.10.
  20. Supports Bartlett Regional Hospital’s strong commitment to the highest standards of business and professional ethics.  Provides services in compliance with all State and Federal laws governing the Hospital’s operations.

 

 

HIM

  1. Supervises Health Information Management staff.
  2. Establishes written, annual objectives and associated plans, which are compatible with the organization’s goals, for the operation of the Health Information Management Department.
  3. Develops and implements specific procedures to provide timely, accurate diagnostic and procedural data to patient accounts to facilitate and optimize cash flow.
  4. Provides orientation and continuing education in-services as necessary to improve the expertise of department and hospital staff personnel in record documentation and health information processing.
  5. Prepares annual budget for the Department following established Hospital procedure, and monitors department budget on a monthly basis, providing explanation of variances.
  6. Interviews prospective employees, hires prospective employees deemed qualified and dismisses employees following the personnel policies and procedures of the Hospital.
  7. Develops and implements specific procedures to ensure that confidentiality of medical records is maintained and HIPPA regulations are adhered to. 
  8. Assures that procedures and practices of the HIM Department conform to applicable accrediting, regulatory, licensing and risk management standards.
  9. Establishes and maintains effective systems for filing, maintenance and prompt retrieving of medical records.
  10. Develops record documentation forms and practices that facilitate documentation and eliminate cost duplication.
  11. Develops and coordinates programs for assessing the quality and utilization of health care services.
  12. Establishes and monitors quality control program and documents control outcomes for periodic employee assessments and evaluations.
  13. Maintains credentialed status by acquiring the appropriate number of CEUs.
  14. Communicates the status of Department operations to Administration, discusses potential problems and submits end-of-month management reports.
  15. Develops and coordinates Department in-service education and training programs and presents opportunities for employee/physician continuing education.
  16. Responsible for relevant computer modules.  Assist managers/staff members with extraction of data from computer modules.

Non-Essential Functions:

  1. Participates in appropriate hospital committees as assigned
  2. Handles special projects as assigned.
  3. Directs counsel to patients as to financial responsibilities; identifies financial options available and assists patients whenever possible.
  4. Maintains good public relations with physician offices, public agencies and insurance companies.
  5. Demonstrates knowledge of the operation and simple maintenance of equipment in the Patient Access Services department.  Initiates service calls when necessary.
  6. Oversees patient related correspondence and complaints.
  7. Oversees Lost and Found and disposes of unclaimed items.
  8. Reviews contracts for third party payers and makes recommendations.
  9. Performs other duties as assigned.

Knowledge, Skills, and Abilities required

  • Ability to use accurate, clear and concise oral and written communication
  • Ability to maintain effective working relationships
  • Ability to explain procedures and requirements to the public and employees
  • Ability to critically think and analyze and communicate findings
  • Ability to work independently and perform assignments with minimal direction
  • Ability to operate a variety of automated office equipment such as personal computers, copy machines, calculators, fax machine, multi-line telephone systems, etc.

Minimum requirements (the following are minimal qualification necessary for entry into this classification)

Education: High school diploma or equivalent required. Graduation from a college or university with a Bachelor’s Degree. Completes annual educational requirements.

License(s):    None.

Certification(s):  None.

Experience(s):  Four years health care financial supervisory experience is preferred. Proven competency in specialty area. Communicates the mission, ethics, and goals of the facility.
PAS     Five years hospital Patient Access Services or related office experience with public contact is required. Preference given for previous supervisory experience in hospital or health care setting. Experience with computerized patient accounting system is required. Familiarity with computer spreadsheet and word processing programs is preferred. Demonstrable verbal and written communication skills are required.
PFS      Experience with computerized patient accounting and admitting systems is required. Experience with computer spreadsheet and word processing programs is required. Demonstrable verbal and written communication skills are required. Familiarity with Medicare and Medicaid rules and regulations is required.
HIM      Experience supervising medical records and familiarity with medical records preferred.

 

Physical:
Ability to sit at a desk or computer terminal for long periods of time, performing paperwork and/or computer data entry.
Ability to see computer screens, read and understand written communications.
Be able to hear and understand verbal and telephone conversations.
Be able to communicate with patients/customers and other hospital staff via verbal or written means.
Ability to lift up to 50 pounds (HIM), 10-15 pounds (PAS & PFS).
Ability to frequently bend, reach, lift, stoop, kneel, reach overhead, bend down, open boxes, stock shelves, and similar duties as needed.
Spend most of the day sitting, working at computer, opening and closing file drawers, and walking between offices.

Meets dress code standards; appearance is neat and clean. Wears identification while on duty. Complies with state and federal laws for employee health requirements, such as TB testing and other requirements (see Employee Health Policy for specific requirements). For specific physical demands of position, including vision, hearing, repetitive motion environment, see attached Description of Physical Demands. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the positions.

Hazardous Exposure/Working Conditions (HIM):
1. Routine duties involve primarily office-related conditions
2. Daily functions may include incidental exposure to chemical and biological hazards, patient contact, needles/syringes, waste handling, moving mechanical parts, and computer use.

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.

To apply, please click here