Director of Revenue Cycle

DEPARTMENT: Patient Financial Services
REPORTS TO: Chief Financial Officer
SUMMARY:
 
Responsible to oversee the development and implementation of current and future strategies to improve revenue results by taking a global view of clinical and financial processes, function and interdependencies. This position will work with Patient Financial Services, the Call Center and Finance on revenue cycle performance to meet the strategic goals of the United Health Centers of the San Joaquin Valley.
 
DUTIES and RESPONSIBILITES
 
1.0 Performance Area #1: General Management – Patient Financial Services and Central Registration - These activities include, but are not limited to the following:
a) Delineates, defines, and streamlines departments various functional activities, to ensure its effectiveness in maximizing the utilization of both asset and people resources.
b) Provides direction, training and support to department supervisors.
c) Implements the necessary guidelines for employees, in accordance with company policies, rules and regulations, due process, and government regulations.
d) Monitors timeliness and effectiveness of department activities, ensuring that insurance and patient billing is accurate and complete.
e) Monitors effectiveness of collection efforts and maintains payment processing is current within the established time frame specified in the department policy.
f) Ensures outstanding customer services are delivered consistently and within department and organization guidelines.
g) Conducts regular and periodic meetings to ensure communication of relevant information pertaining to the team is cascaded to the proper channels within the team in particular and the organization in general.
h) Implements and supports performance coaching and staff counseling.
i) Designs and develops training programs that are relevant and necessary for the continuous development of the technical competencies of the team.
 
2.0 Performance Area #2: Developmental – Finance:
 
a) Develops policies, guidelines, and implements procedures for grant management and reporting and ensures compliance with regulating agencies requirements.
b) Ensures grant funds are applied within the prescribed limits of budget plans and fiscal guidelines.
c) Compiles and prepares various performance reports for management in order to analyze trends and make recommendations.
d) Develops an understanding of the company’s financial performance, reading financial statements and applicable ratios.
e) Works closely with the CFO to develop and formulate performance measures, success factors and standards for the revenue cycle process.
f) Enhance and standardized work-flow processes throughout the revenue cycle to assist in achieving consistency in maintaining the critical success factors outlined in UHC’s standard operating procedures.
 
3.0 Performance Area# 3 – Compliance
 
a) Ensures patient information is stored securely and handled in compliance with HIPAA privacy and security regulations, if applicable.
b) Implements state and federal regulations when applicable.
 
4.0 Performance Area #4: General Corporate Expectations
 
a) Attends and actively participates in all meetings (e.g., department meetings, program meetings, employee staff meetings) and other activities as required or assigned.
b) Attends workshops/seminars as necessary to increase skills and knowledge to provide effective care, treatment, and/or leadership.
c) Supports the overall needs of the health center by working flexible or extended hours when necessary.
d) Supports the needs of the health center by traveling to other health centers when needs dictate the need for personnel
e) Demonstrates awareness of, and compliance with, organizational mission and objective of UHC to provide health care access and support services for all members of the community.
f) Supports their own staff development by completing the required hours of continuing education each year
g) Other work-related duties as assigned by supervisor. Duties and responsibilities may be added, deleted, or changed at any time at the discretion of management, formally or informally either verbally or in writing.
h) Maintains confidentiality and respect for information regarding patients and other team
i) members; abides by UHC Rules of Confidentiality and general HIPAA regulations
regarding privacy.
j) Displays a positive, professional and respectful demeanor at all times toward employees, peers, professional contacts, and patients served, maintaining a professional appearance and positive image for the health centers.
k) Contributes to the team by promoting positive staff interaction, maintains open communication with other programs/departments.
 
QUALIFICATION REQUIREMENTS:
 
EDUCATION AND LICENSE/CERTIFICATION:
 
· Bachelor’s Degree in Business Administration or equivalent work experience required.
 
PRIOR EXPERIENCE:
 
· Five (5) years of health care related business management experience.
· FQHC experience is desirable.
· Experience in medical revenue cycle management experience is required with a consistent track record of achieving metrics.
· At least two (2) years of supervisor experience successfully resolving a variety of people issues.
· Must have strong knowledge of medical insurance billing and collections with CPT and ICD9-10 coding and medical terminology, as well as an overall understand of PPS reimbursements
· Proficiency in Microsoft Office (Outlook, Excel, Word, and PowerPoint).
 
PHYSICAL REQUIREMENTS:
 
· Must be able to lift up to 25 pounds and push up to 40 pounds (on wheels).
· Must be able to hear staff on the phone and those who are served in-person, and speak clearly in order to communicate information to clients and staff.
· Must be able to have vision that is adequate to read memos, a computer screen, personnel forms and clinical and administrative documents.
· Must have high manual dexterity.
· Must be able to occasionally reach above the shoulder level to work, must be able to bend, squat and sit, stand, stoop, crouching, reaching, kneeling, twisting/turning, fingering and feeling.
This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may changes as needs evolve.
Final candidates for this position will be subject to background screening in accordance with company policy.
 
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