Location: Randolph, Vermont - Hybrid (Client will be providing accommodation for non-locals.)
Duration: Fulltime
Job responsibilities: • Provides sound leadership and financial oversight of Patient Financial Services, Revenue Integrity (including CDM management), Reimbursement, Coding/Auditing, HIM, and Registration. • Accountable for ensuring Coding & Auditing practices are compliant. • Lead a team of highly functioning experts in the CDM, charge capture, and revenue analysis areas for hospital and clinic/professional services. • Monitors regulatory literature; develops, modifies and maintains departmental policies and procedures as necessary to respond to evolving competitive and regulatory climate. • Work effectively with other departments across the continuum of care. • Creates education plan for revenue integrity, revenue cycle operations, and clinical/operational departments to improve reimbursement, reduce revenue leakage, and improve compliance. • Supports the CFO in the evaluation of new service/business development, identifying opportunities for billing for new services (proper billing codes, CPT codes, documentation requirements, etc.). • Supports the CFO in the development of the revenue model, inclusive of determining and establishing the desired effective charges and rates for the annual budget process. • Works collaboratively with the finance and accounting team to file the annual MCR Cost Report as well as maintain an internal cost report model to appropriately book third party reserves. • Reviews and analyzes all payor contracts for the organization and reports findings to Chief Financial Officer for final review and approval process.
. Directs team in any analytics needed to support the payor contracts approval process and/or negotiation. • Establishes relevant performance goals and expectations.
. Develops and produces executive and board level CDM, Revenue Cycle, and Revenue Capture dashboard reporting.
. Prepares annual objectives, plan of action and budgets, as appropriate.
. Monitors benchmark data related to revenue cycle performance. • Collaborate with Clinical, Financial, and Operational Executives to develop and execute strategies and initiatives which improve performance and mitigate risks. • Implement leading practices for CDM, Charge Capture, and revenue leakage prevention. • Develop and update policies and procedures related to the resolution of all revenue cycle issues associated with billing, accounts receivable, denials, and insurance collections, charge master, charge capture, reconciliation, appeals, revenue management and revenue leakage prevention.