Assistant Director of Revenue Cycle

About the role

Join our Revenue Cycle team and play an essential role in supporting exceptional care through accuracy, collaboration, and service.

Responsibilities

• Assists in supervision of Revenue Cycle (RC) staff to ensure that all benefits/eligibility, authorization and billing are processed timely/accurately for Hospice.
• Assist in monitoring progress with eligibility coordinator (EC) staff on timeliness of patient payor entry prior to admission and status changes billing updates.
• Review of benefit period set up to ensure compliance.
• Review transfer in patients and discharge reason information for accuracy.
• Monitor daily notice of election (NOE) front end work with EC staff and ensure submission of NOE/NOTR remains timely within 5-day rule.
• Follow through to paid status and monitor NOE return to provider (RTPs) and address any overlap issues as they occur.
• Assist in pre-billing Medicare reviews in electronic medical record (EMR) and report to RC Director as needed.
• (open clinical visits, validation holds)
• Ensure Medicare claims are processed timely and review reasons for error and claim holds.
• Review claim RTP/denial weekly.
• Maintain Medicare Hospice A/R aging to reduce total AR and resolve current follow up issues.
• Working with other agencies to resolve overlap issues timely.
• Aid in review of financial assistance applications as needed, for percentage of charity to be applied and communicate with staff/family.
• When needed assist with charity write off and post back adjustments in system.
• Aid in creating Nursing Home Room & Board invoices or process invoices received from facilities billing offices prior to claim submission to ensure TennCare pass through billing and compliance.
• Forward completed invoice to Accounts Payable for payment processing.
• Aid as needed to create Nursing Home Room & Board invoices or process invoices received from facilities billing offices prior to claim submission to ensure TennCare pass through billing and compliance.
• Assist with new EMR setup to gain knowledge to oversee the administration of software setup related to billing compliance.
• Jointly with RC Director, collaborate with Information Technology and software vendors.
• As needed to assist in communication with credentialing company (Teleios (TCN) to maintain mal-practice application and forward Certificate of Insurance documents to Human Resources & TCN.
• Stays current with CMS regulations as related to claim process.

Requirements

• College accounting preferred; five to eight years’ experience or equivalent combination of education and experience.
• Experience in medical accounts receivable preferred, including responsibility for daily operations of the department.
• Knowledge of Medicare DDE System.