Chief Revenue Officer (MT4109 - Corporate)

Duties And Responsibilities

• Formulates objectives, policies and procedures related to all related revenue cycle activities within the organization and communicates these policies and procedures to appropriate staff for execution.
• Ensures compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers.
• Maintains current knowledge of all changes and proposed changes by federal and state regulators, particularly Medicare and Medicaid, as they relate to billing and coverage changes.
• Provides the final decision on billing issues when disputes arise.
• Plans, manages and completes regular and special projects associated with revenue cycle improvement.
• Analyzes payer trends, internal revenue cycle reports, productivity measures, case mix trends, and denial trends to identify and affect appropriate change to maximize reimbursement.
• Maintains appropriate internal control safeguards over AR records and collection of cash.
• Affords analysis of cash collections to identify underperforming payers and prioritize claims most likely to pay.
• Develops and maintains relationships with payers to ensure prompt resolution of payment issues.
• Provides initial and ongoing education to all departments on Revenue Cycle initiatives as they are identified.
• Directs ongoing programs for staff development to include establishing multi-disciplinary revenue cycle teams to assist in enhancement of both quality and efficiency.
• Participates, in concert with Human Resources, the recruitment, interviewing, hiring, and disciplinary actions of business office staff.
• Completes annual and periodic performance evaluations of business office staff.
• Presents to others in writing, via telephone or directly in a personal and professional manner.
• Obtains a 4.5 rating or above in the inter-department service survey.
• Obtains a 3.5 overall rating in quarterly leadership empowerment survey.
• Recommends operating and capital budgets and monitors allocation of resources.
• Works with other executives as required, including systems evaluation and upgrades, cash forecasting, billing and collection data, statistical information, monthly revenue and receivables aging, periodic Medicare cost reporting, cash delinquencies and schedules.
• Advocates for the Center and serves as liaison to local and state professional societies, as well as to local and state officials, organizations, and third-party payers, as appropriate.
• Performs other related duties as assigned.

Job Qualifications

• Bachelor’s degree from an accredited college or ten years of proven, progressive experience in healthcare revenue cycle management, which includes five years of management experience; Master’s degree preferred.
• Knowledge of Health Resources Service Administration and Texas State insurance regulations relating to healthcare billing and collections including medical, dental, behavioral health, and specialties, and value-based and managed care contracting.
• Familiarity with clinician credentialing rules, PPS payment model, ICD-9-CM and ICD-10-CM and CPT coding; familiarity with medical terminology.
• Experienced use of Microsoft Office; experienced use of Excel.
• Knowledge of integrating artificial intelligence, automation, and/or robotics into revenue cycle process.