DIRECTOR OF REVENUE CYCLE

Responsibilities

• Contributes to the achievement of excellence in health care by successfully developing and implementing both strategic and operational department goals for his/her department, including but not limited to Operational Improvement, Recruitment & Retention, Staffing, Budget, Quality & Performance Improvement, Team Building & Effective Communication.
• Operational Improvement
• Identifies and clearly communicates departmental vision which demonstrates a high commitment to improving patient experience and the work environment.
• Develop and implement strategies to minimize bad debt, enhance revenue capture, and improve cash flow.
• Collaborate with various stakeholders to align revenue cycle activities with the hospital’s strategic goals.
• Monitor and analyze financial data to make informed decisions regarding staffing and budget.
• Create business plans and justify variances while analyzing the cost-benefit of programs.
• Ensure compliance with federal and state regulations.
• Successfully develops, communicates, and achieves departmental goals and objectives.
• Implement process improvements to optimize the revenue cycle.
• Track metrics and report trends, making recommendations for areas of improvement.
• Oversee the business office functions, including patient billing, collections, and customer service.
• Ensure accurate and timely processing of claims and payments.
• Develop policies and procedures to improve business office efficiency and effectiveness.
• Prepare and present regular reports on revenue cycle performance to senior management.
• Utilize data analytics to identify trends, forecast revenue, and make strategic recommendations.
• Ensure transparency and accuracy in financial reporting and compliance with regulatory requirements.
• Oversee patient access services, including scheduling, registration, and insurance verification.
• Ensure a smooth and efficient patient intake process to enhance patient satisfaction.
• Develop and implement policies to improve patient access operations and reduce wait times.
• Measures performance against KPIs and industry benchmark data in the revenue cycle to ensure the organization is maximizing revenue.
• Manage a diverse team, ensuring quality documentation and clinical consistency.
• Guide department leaders for effective resource allocation based on patient volume and budget constraints.
• Cooperates with other departments to support and enhance patient flow and works well with the Leadership Team for a unified approach to management.
• Designs and implements planning processes at departmental level which integrates into the Hospital’s strategic plan.
• Contributes to the effective management of the department through the consistent application of Hospital policies and procedures.
• Participates actively in Hospital councils, committees and task forces.
• Demonstrates staff and physician satisfaction improvement through measurable venues.
• Demonstrates staff participation in improvement initiatives.
• Uses unit data to creatively improve patient care as evidenced through PI plans and reports.
• Uses creativity and professional interdependence in decision making.
• Remains visible to staff and offers assistance when needed.
• Recruitment and Retention
• With input from staff, develop an annual department-specific recruitment and retention plan to enhance communication and interpersonal relationships, improve productivity and departmental systems to improve morale and reduce turnover.
• Assists staff in developing goals and objectives for individual growth and development to meet current and future department needs.
• Provides orientation and in-service training for department staff to promote professional growth.
• Creates a positive work environment which promotes bilateral communication and recognizes/rewards excellence.
• Proactively and timely addresses conflict through use of the Hospital’s conflict resolution program.
• Provides ongoing constructive feedback regarding performance/behavior, including timely completion of probationary and annual performance reviews and timely resolution and management of performance issues. Responsible for completion of 95% of department performance evaluations by annual evaluation due date.
• Supports collaborative, patient-centered interdepartmental relationships.
• Maintains positive interpersonal relationship with staff.
• Supports professional growth of staff and self.
• Staffing
• Supervises staff to ensure a high level of productivity and quality of work.
• Interviews and recommends for hire competent staff according to Human Resource policies and employment laws.
• Determines the staffing needs, work methods and performance standards to ensure appropriate coverage to meet operational needs.
• Verifies annually Licensure/Certification for staff where required.
• Reduces sick calls, tardiness and instills a committed work ethic to staff.
• Promotes teamwork among unit staff and staff in other departments.
• Budgetary
• Achieves budgetary and financial goals through establishing and effectively managing variable departmental budget within 2% of budget, according to utilization assumptions.
• Ensures effective utilization of staff to maximize productivity while maintaining quality operations.
• Plans effectively the use of the department’s staff resources, supplies, capital equipment and other non-labor expenses.
• Eliminates/minimizes the use of temporary agency nursing staff.
• Eliminates/minimizes the use of staff overtime, bonus or mandatory overtime.
• Quality/Performance Improvement
• Identifies and implements quality improvement programs to enhance services and improve both efficiency and effectiveness of operations.
• Supports the Quality Improvement initiatives by providing coverage for team members to attend meetings and complete assignments, as appropriate.
• At a department level, reviews and approves, as appropriate, performance improvement changes and ensures ongoing monitoring and evaluation to meet stated objectives and improve patient experience.
• Promotes a customer-oriented staff by encouraging the staff to be responsive to customer needs.
• Participates in interdisciplinary and department projects to improve patient care and the hospital environment.
• Demonstrates department audits show compliance with all Regulatory Agency and quality standards at required compliance levels (%).
• Team Building and Effective Communications
• Clarifies roles, responsibilities and expectations within the team
• Encourages team members to share best ideas and practices in order to help one another
• Recognizes and rewards both individual and team achievements
• Fosters an environment of teamwork and collaboration through mutual respect and effective communication
• Listens and effectively interacts with others without alienation of others
• Demonstrates an effective communication style with all levels of personnel
• Actively builds upon the feedback of others
• Demonstrates the ability to manage the patient accounting system and to insure acceptable accounts receivable levels are maintained, as determined by industry standards and annual hospital objectives.
• Collaborates with Chief Financial Officer to plan financial goals consistent with organizational mission and fiscal strategies.
• Evaluates and monitors effectiveness of methods to insure timely receipt of payment on self-pay accounts.
• Maintains appropriate controls over cashiering function and coordinates with general accounting to insure proper cash balancing and reconciliation procedures are maintained.
• Prepares and analyzes month end reports to track trends in receivables and prioritize follow up activity.
• Participates in Finance Committee meetings to clarify AR issues and status.
• Strives to improve the automation of routine billing and collection functions by maintaining and implementing current edit programs and maximizing system resources.
• Monitors daily productivity reports to insure timeliness of all billing activity.
• Tracks AR reports, cash posting activity, exception reports, etc. and works with other departments, such as Med Info to expedite release of accounts for billing.
• Assists staff by personally handling complex problem accounts to facilitate resolution.
• Involves staff in setting goals for reduction/improvement in AR levels.
• Responsible for compliance with all state and federal requirements related to submission claims including interpretations, implementation, testing and training.
• Approves all bad debt and free care transactions in accordance with established budgets.
• Provides quality driven customer service systems to ensure patients’ rights are maintained.
• Encourages “the patient is always right” philosophy so all patients will have a positive first impression.
• Motivates staff to handle difficult situations with tact and diplomacy.
• Assists staff to prioritize activities for patient convenience and satisfaction.
• Coordinates and researches complaint issues with the patient advocate; responds directly to problems in writing.
• Collaborates with other departments to facilitate the exchange and improve the accuracy of patient information from the registration process through account finalization.
• Appropriately monitors the AR/ADT system’s effectiveness, implementing system upgrades and maintaining programs and functions.
• Documents and reports to vendors any problems with functionality. Follows up to ensure corrections are made.
• Ensures all third-party changes are implemented on a timely basis by working with vendors and intermediaries to meet required timelines.
• Responsible for all system generation of all bills, forms and reports.
• Responsible for maintenance of all host system AR/ADT master files; insures all related and affected functions are in sync, updates are current and operational.
• Ensures that PC based software and hardware problems are resolved quickly to minimize downtime.
• Works with other departments on interface implementations and maintenance to ensure all information is accurate and complete.
• Participates in, or is directly responsible for, decisions related to selection of new systems for the business office.
• Continually seeks opportunities for improvement in system functionality.
• In a manner consistent with the hospital’s mission, vision and strategy, provides managerial direction and supervision to all Business Office departments to insure effective operation.
• Reviews all requests for supplies and equipment, monitors budget compliance.
• Plans alternative methods of covering routine duties by recruiting volunteers or utilizing off shift personnel.
• Encourages TQM methods by empowering staff members to assume responsibility for decision making and problem solving.
• Ensures all departments conduct regular staff meetings.
• Standardizes existing procedures for more efficient daily operations.
• Exhibits a good understanding of the Vermont regulatory and reimbursement environment by recognizing the importance of employing effective networking methods and establishing ongoing relationships with intermediaries and other providers.
• Regularly attends healthcare financial management meetings.