Director, Revenue Cycle Resume Sample
Camren Hackett
39014 Glover Pine,
Los Angeles,
CA
+1 (555) 865 1653
Work Experience
Director, Revenue Cycle
03/2017
-
PRESENT
Los Angeles, CA
- Formulate and make recommendations to Assistant Administrator Finance and the Managing Director, Patient Access on policies and practices relating to Revenue Cycle operations
- Ensure compliance with administrative/legal requirements of government regulations concerning Medicare, Medi-cal, Workers' Compensation, bargaining unit contracts and organizational fee schedules
- Ensure adequate internal controls are in place Recruit, develop and maintain a competent and productive team; responsible for staff development and related goal setting/performance standard with the Revenue Cycles managers and staff
- Delegate authority to unit managers for management of day-to-day operations and the completion of special projects Partners with KFH/KFHP Local Managers and Senior Local Medical Group Manager to establish a single, strategic, integrated operational business plan to optimize the billing and collection of nondues revenue
- Develop and strengthen the Revenue Cycles relationship with senior management in health plan/hospital, in order to improve the level and quality of joint decisions being made that have financial, legal and regulatory implications to the Revenue Cycle organization
- Provide leadership in the development of non-dues revenue financial forecasts, budgets, and reports for their areas of responsibility
- Represent and act on behalf of the Assistant Administrator for Finance and the Regional Managing Director for Patient Access in numerous special projects and committees involving key regional, facility, and divisional managers
Director, Revenue Cycle Systems
04/2010
-
11/2016
Detroit, MI
- Responsible for the development and adherence to payroll and non-payroll budgets
- Accountable for resources being distributed and applied appropriately to meet deliverables
- Ensure department operates within budget
- Completes work assignments within an acceptable time frame
- Uses time and resources to the best possible advantage for successful completion of job responsibilities
- Consistently exhibits behavior and communication skills that demonstrate HealthCare Partners’ (HCP) commitment to superior customer service, including quality, care and concern with each and every internal and external customer
- Uses, protects, and discloses HCP patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
- Contributes to and supports the corporation’s quality initiatives by planning, communicating, and encouraging team and individual contributions toward the corporation’s quality improvement efforts
Senior Director, Revenue Cycle
09/2003
-
03/2010
Houston, TX
- Directs the Billing team and operations including Distribution, Data Entry, Eligibility, Coding, Accounts Receivable, Collections, Patient Account Services, payment posting, System Support, etc..
- Ensures all teammates are knowledgeable on Billing Department’s SOX Narrative and follow all processes. Ensures adherence to SOX Narrative
- Provides oversight for organization’s clinical documentation improvement program in a standardized manner and oversees the integrity of financial and clinical interfaces, while facilitating the development of strategic system planning
- Work with Epic representatives, other departments, ARCR Teamand URMC’s Clinical Informaticists to ensure the system meets needs
- Ensure claims meet payor’s definition of acceptable claim in form and content
- Be accountable for providing leadership and financial reporting and support across RCM, partnering with Finance & Accounting groups such as Accounting, Accounts Payable, Payroll, Financial Planning, Compliance, Program Management, Treasury, Tax, Audit, and others
- Be responsible to develop, implement, and monitor financial policies / procedures across RCM and design KPI to drive financial goals
Education
Strayer University - Newport News Campus
1997 - 2002
Bachelor's Degree in Business
Professional Skills
- Math skills, strong organizational skills, working knowledge of all types of healthcare insurance
- Experience managing complex/large scale/ transformational projects, including demonstrated success in coordinating major projects
- Prior experience managing Revenue Cycle or a Business Office in a Healthcare setting, preferably acute care
- Previous experience working within a billing department
- Experience in a complex shared service environment with multiple reporting relationships
- Prior oversight of $80M+ operations
- Experience in revenue cycle systems implementations with an emphasis on workflow
How to write Director, Revenue Cycle Resume
Director, Revenue Cycle role is responsible for insurance, training, software, reporting, health, leadership, healthcare, research, finance, integration.
To write great resume for director, revenue cycle job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Director, Revenue Cycle Resume
The section contact information is important in your director, revenue cycle resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Director, Revenue Cycle Resume
The section work experience is an essential part of your director, revenue cycle resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous director, revenue cycle responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular director, revenue cycle position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Director, Revenue Cycle resume experience can include:
- Be responsible to ensure effective financial internal controls exist in compliance with GAAP, regulatory laws, and reporting PH&S rules
- Experience working in heavily regulated environment, required
- Extensive experience in revenue cycle performance, including knowledge of best practices required
- Identifies and develops a leadership team that demonstrates serving leader principles and raises employee engagement
- Communicate experience to Senior Management
- Five years Leadership experience, required
Education on a Director, Revenue Cycle Resume
Make sure to make education a priority on your director, revenue cycle resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your director, revenue cycle experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Director, Revenue Cycle Resume
When listing skills on your director, revenue cycle resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical director, revenue cycle skills:
- Strong communication skills both written and verbal, including the ability to present information in an effective manner required
- Progressive billing experience including experience in across specialties in a multi-payer setting
- Project management experience is highly desired Experience with Xifin Software is highly desired
- Knowledge of the principles of Information Systems in order to effectively analyze and make decisions, ideally familiarity with the Meditech system
- Medical terminology knowledge and procedural coding required. Computer experience including; Excel, Word, Medical Billing Software Applications
- Work in a fast-paced and changing environment; flexible and quickly adaptable to changing priorities
List of Typical Experience For a Director, Revenue Cycle Resume
1
Experience For Director, Revenue Cycle Systems Resume
- Manages team to effectively meet goals and objectives
- Accountable for all day to day operations, 24/7. Ensures timely scheduling and appropriate staffing levels to provide good customer service
- Management experience in revenue operations in a Meditech environment
- Oversees and directs planning, organizing and implementing Patient Access and HIM processes and functions, including Information Desk
- Basic accounting procedures with some accounting background in a medically-related environment required
- Directs use of outside consultants including contract negotiations and third party billing
- Partner with Systems Finance team in the capital planning process (capital requests and life cycle replacement schedules)
- Work with Financial Planning & Strategy to develop continuous evaluation of short and long term strategic finance objectives
2
Experience For Senior Director Revenue Cycle Management Resume
- Coordinates, facilitates and/or participates in periodic meetings and training workshops
- Oversees the day-to-day operations of hospital billing, denials, appeals/follow-up
- Operational Planning and Management
- Participates in and oversees staff interviews, hiring, terminations and disciplinary actions in accordance with Hospital policies
- Assists in computer system upgrades, testing, and oversees smooth function of all systems
- Report on conformity with approved budget; identify discrepancies, and partner with RCM Leadership to establish action plans
- Has the ability to represent the revenue cycle within the organization
- Develop and sustain excellent working relationships with AMR professionals (e.g., Operations, Business Development, IT and Finance), as well as with the Company’s clients, payors, consultants, banks and financial intermediaries and government agencies
- Promote an environment of mutual respect, courtesy and value of others’ opinions/ideas
3
Experience For Senior Director, Revenue Cycle Resume
- Work well with other leaders to communicate and share resources on critical projects. Seek opportunities to help others’ projects by sharing and reallocating team members’ priorities and assignments
- Serves as onsite leader for customer service (patients, patients’ families and physicians) questions /requests and ensures a timely and comprehensive response
- Provides Entity with updates on new initiatives within the PHC Revenue Cycle, designed to improve billing performance. Consults with Revenue Cycle peers to identify issues and trends that contribute to variances and below par performances
- Serve as the onsite leader for department managers, clinical staff, and entity management team to obtain information or clarification on PHC standard Revenue Cycle policies, procedures, guidelines, and regulatory requirements
- Lead PHC Revenue Cycle and departmental committees and meetings designed to improve Revenue Cycle operations/processes, as necessary
- Act as a liaison for facility specific payer issues to ensure optimal processing and reimbursement, communicate findings to Piedmont revenue cycle stakeholders, define solutions and initiate resolution
- Develops and deploys collections and reimbursement strategies in collaboration with Corporate and Divisional management
4
Experience For Director Revenue Cycle Resume
- Oversees the receivables management operation on multiple platforms for the division utilizing divisional and corporate resources to allow for maximization of revenue for FMS. Ensures compliance with all pertinent divisional, company and regulatory requirements, policies and guidelines
- Measure performance of revenue centers. Monitors monthly and annual AR trends and other pertinent performance metrics, providing analyses, observations and recommendations to management to drive continuous improvement efforts in all areas of the revenue cycle
- Drives the performance of the employees by establishing expectations/goals, providing informal feedback throughout the year and formal feedback in the form of the annual performance evaluation
- Monitors all major issues impacting divisional reimbursement operations and collections, ensuring appropriate actions are taken to address identified issues and providing guidance and expertise as necessary to ensure an effective and suitable resolution
- Responsible for all aspects of billing and collections for all Fidelis products including ensuring accurate billing of rates, and membership by product updates
- Provide SME analysis of billing, collections and outstanding receivables to Senior and Executive Management
- Develops and provides root cause analysis protocols to assist in the identification and correction of system failures impacting the revenue cycle
- Works with team to gather requirements, design, install and maintain accurate and efficient revenue cycle workflow
5
Experience For Senior Director Revenue Cycle Resume
- Develops strategies to forecast and prepare for system changes in advance of governmental or other
- Acts as a collaborative partner with all AHN revenue-impacting teams by participating in key meetings and acting as a liaison with information technology; this includes the vetting, tracking, and management of trouble tickets to ensure validity of system issues and timely and appropriate resolution
- Develops documented workflow designs based on business needs, including executive summaries and
- Assists revenue cycle education leadership with the development of job aids and other training materials
- Expert understanding of general flow for all areas of a hospital revenue cycle, from scheduling to coding and charging to billing, adjustments and payment in full
- Provides guidance and strategic direction to a team of Revenue Cycle Professionals
- Develop data structures to facilitate the analysis of revenue and rate trends that exist within the business and coordinate with medical economics and actuary to recommend cost-saving initiatives in a meaningful way
- Collect, analyze, and summarize information in order to prepare standard and ad hoc financial reports
6
Experience For Director Revenue Cycle Operations Resume
- Recruit, select, orient, and train employees in order to maintain staff to meet objectives. Provide information, educational opportunities, and experiential growth opportunities in order to develop staff. Plan performance expectations
- Managed care and healthcare experience, required
- Monitor compliance of departmental policies and procedures to meet organizational initiatives and regulatory requirements
- Proficiency in Microsoft Office: Excel, Word, Access; Outlook; PeopleSoft; Crystal Reports
- Act as a technical expert in regards to financial class responsibility to answer questisn raised by clients and team members
- Establish sound revenue cycle procedures that are proven industry standard best practices and support CBO performance metrics that foster client confidence with services performed by the CBO
- Take primary ownership of managing customer relationships and is accountable for positive business office results both in revenue cycle performance and with patient and client satisfaction
- Recognize when results are not achieved and determine how to turnaround the results and actively communicate with the Facility Administrator
7
Experience For Director, Revenue Cycle Mangement Resume
- Develop operational and financial reports
- Selects and hires employees according to established guidelines. Monitors, coaches, develops and evaluates staff performance in accordance with applicable performance standards
- Oversees training and ensures staff competencies
- Ensure CBO staff follows SCA and CBO policies, procedures and internal controls
- Ensure revenue cycle processes support compliance guidelines and all teammates are trained appropriately. All teammates are trained and educated for their job specific function. Promote a “learning” environment
- Progressive supervisory experience required
- Responsible for the successful operation and performance of the centralized-business office, revenue cycle hospital services for Steward Health Care System
- Proven knowledge of hospital operations including best practices regarding workflow, quality monitoring, coaching and training - to lead a team to maximize cash performance & DSO management
8
Experience For Director Revenue Cycle Ops Resume
- Directly oversee multi-specialty revenue cycle(s)
- Resolve complex issues and interface directly with high-level operations and stakeholders
- Analyze insurance payer agreements
- Maintain and keep current practice management software
- Calculate and maintain payer tables and produce revenue accrual in direct alignment with payer contracts
- Oversees all aspects of the Epic Revenue Cycle system implementation, by providing strategy, decision support, organisational planning and operational leadership to deliver a world class patient experience
- Oversees all aspects of RCM innovations and operational enhancements/ standardisation by leveraging best practices and technology and providing strategic direction to create cohesive, compliant, streamlined and efficient environment that provides a world class patient experience
- Coordinates and works collaboratively with CCF enterprise RCM leadership team to ensure consistency with best practices and lessons learned; shares information regarding performance, opportunities for improvement, and participates in strategic planning initiatives
- Provides leadership for developing and overseeing the processes and systems to improve outpatient registration, admission, financial performance, and generate cash flow
9
Experience For Assistant Director, Revenue Cycle Operations Resume
- Establishes and manages multiple budgets and departments; manages performance to budget
- Stays abreast of all applicable regulations and ensures system compliance
- Works with stakeholders to understand complex issues, recognise decision points, and design and deliver creative solutions while partnering with a wide variety of constituencies including physicians as business partners
- Leverages CCF expertise and partners with London community to develop a differentiated business model in the market by collaborating with payers, HealthCode, etc
- Provides overall decision support, organizational planning and operational leadership toward accurate and timely accounting, balancing and reporting of patient revenue
- Develops, implements and monitors action plans to address improvements in account receivable management
- Works with CCF RCM Financial Reporting on the development and maintenance of financial planning reports; leverage the reports to effectively manage RCM operations, drive accountability, desired outcomes, and provide reports to various levels of leadership
- Communicates with executives across the organisation
- Quality Control: Evaluates, recommends, and implements changes to improve Patient Access and HIM department processes and to optimize reimbursement to the hospital. Responsible for involving staff in continuous quality improvement activities; motivates and empowers staff to improve. Monitors and reports quality improvement activities
10
Experience For Director, Revenue Cycle Management Resume
- Responsible for the planning, organization and directing Patient Access Department and HIM activities and personnel. Establishes standards of performance and development and implement of policies, procedures, and objectives for the Department
- Provides for all Department staff orientation, in-service training, and continuing education
- Responsible for staff personal development and professional growth through seminars, conferences, staff meetings, etc
- Responds to special problems and emergencies as needed on a 24/7 hour basis
- Participates in Patient Safety Initiatives and trains staff appropriately
- Monitors Revenue Cycle Dashboard metrics, implement initiatives to improve metrics including POS cash collections, Medicaid application completion, Revenue protect compliance, DNFB, and Clean Claim rates
- Attends meetings as required and participates on committees as requested; chairs and coordinates activities of the Registration and Scheduling Workgroup. Attends Medical Records committee
List of Typical Skills For a Director, Revenue Cycle Resume
1
Skills For Director, Revenue Cycle Systems Resume
- Effective personal communication skills, shares knowledge with excellent training skills
- Excellent cross-functional team participation skills
- Prior experience managing a P&L or budget
- Experience in Revenue cycle with 5+ years of senior leadership experience in medical billing and revenue cycle is required
- Adept negotiation skills with the ability to influence diverse audiences
- Experience building/managing a team
- Participate in CQI and process design/reengineering or other committees designated to improve effectiveness/efficiency of the business
- Excellent technical understanding and analytical ability
- Management experience in leading large claim volume revenue cycle
2
Skills For Senior Director Revenue Cycle Management Resume
- Works with senior leadership to develop long term strategic roadmap to consolidate enterprise revenue cycle system portfolio
- Communicate with the Executive Team as needed and build effective relationships across all functions of the business
- Commitment to integrity and quality, with a strong work ethic
- Understanding of compliance programs associated with Revenue Cycle department
- Maintain current and thorough knowledge and understanding of revenue operations policies, procedures, and federal/state billing regulations and guidelines
- Thorough understanding of relevant Medicare/Medicaid billing and reimbursement requirements, utilization management, and managed care principles
- Assist in providing support to other finance departments such as accounting, and coordinate with those departments on monthly close
- Responsible for day-to-day operations, associated with all physician practices, for all processes associated with Physician Billing Services
- Coordinates all aspects of the revenue cycle for physician billing performed by PBS, including charge capture, registration, co-pay collection, charge posting, denial management, coding, billing, and receivables management
3
Skills For Senior Director, Revenue Cycle Resume
- Oversees processes involved with Denial Management and performs monthly analysis to identify trends and training needs. Coordinates the training and/or feedback to initiate process improvement and decrease denial % rates
- Establishes and maintains a system of compliance with federal and state documentation and billing requirements. Implements systems to insure such compliance is maintained
- Math skills, strong organizational skills working knowledge of all types of healthcare insurance
- Leadership ability with effective communication, motivational, and critical thinking skills
- Facilitates the 3rd party payor credentialing process for physicians whose practices are managed by PBS
- Develops financial programs consistent with changing regulatory and fiscal environment in accordance with Health System’s mission and vision
- In-depth knowledge of healthcare billing and collection practices
4
Skills For Director Revenue Cycle Resume
- Knowledge of CPT, HCPCS, and ICD-10 coding
- BA/BS in Accounting, Finance or related study required
- Knowledge of CPT coding, ICD-9 and ICD-10
- Broad understanding of healthcare revenue cycle processes and key metrics of success
- Analyze Key Performance Indicator (KPI) data and coordinate Revenue Cycle analytics, utilizing all available data
- Communicates progress toward goals and continuing obstacles to Facility Administrator and RVP
- Develops standardized PBS systems and processes to support smooth practice operation and high levels of customer service across the Organization
5
Skills For Senior Director Revenue Cycle Resume
- Produces detailed monthly “dashboard” reports for each entity, indicating patient volumes, charges, cash, A/R balances, etc, in order to manage the processes and people involved with providing consistent, predictable AR performance
- Meets with physicians and Frontend Revenue Cycle Manager, on a regular basis to discuss the contents of the monthly reports
- The ability to analyze and evaluate information, exercise own judgement, interpret hospital policies and procedures, anticipate department needs
- Develops and executes workplans to complete enterprise design; implementation of enterprise revenue cycle systems and transformed workflows for remaining medical group practices and hospitals
- Facilitates complex integrated enterprise design session to drive often divergent senior leaders to a single enterprise decision to serve as the foundation for the build of future state applications and workflows
6
Skills For Director Revenue Cycle Operations Resume
- Serves as intermediary between facility and centralized coding for coding-related questions impacting revenue cycle
- Develops, manages and maintains self pay pricing to assist uninsured/uninsured patients with appropriate quotes for costs of care
- Monitor and research regulatory changes and propose actions to respond to changing legislation/regulations
- Provide accurate and timely reporting of performance metrics to senior leadership team as required
- Ensures chargemaster compliance and optimization for all hospital departments
- Reviews denial trends and works with service lines owners to improve documentation, compliance or awareness of denial sources
7
Skills For Director, Revenue Cycle Mangement Resume
- Demonstrates a commitment to facilitating patients’ movement through the continuum of care in a timely manner to optimize outcomes as well as utilizing resources effectively
- Reviews UR requirements for status and level of care versus actual assignment
- Develop and implement policies and procedures related to all aspects of the revenue cycle process
- Perform operational reviews of revenue cycle processes and publish recommendations
- Participate in continual education programs and activities that pertain to healthcare management, as well as specific functional areas
- Provide analysis of results, trends, and best practices
8
Skills For Director Revenue Cycle Ops Resume
- Develop and maintain positive working relationships between DaVitaRx centers, IT, Payor Contracting, Compliance, and Revenue Operations; collaborate with these departments to meet key business objectives
- Develop, implement, and refine systems and processes as needed
- Develop and monitor department budgets; manage expenses to meet budget guidelines
- Positive attitude with a customer service mentality toward internal & external stakeholders
- Passionate for both personal and corporate success
- Intermediate proficiency within Excel (e.g. ability to create pivot tables& formulas)
- Ability and willingness to travel up to 15% to Arizona
9
Skills For Assistant Director, Revenue Cycle Operations Resume
- Based in Las Vegas, Nevada
- Knowledge of how to analyze accounts receivable, denials, and to post denials correctly to account
- Compliance, Law & Ethics (HIPPA)
- Commitment to and role model of DaVita’s values of Service Excellence, Integrity, Team, Continuous Improvement, Accountability, Fulfillment and Fun with ability to demonstrate those positively and proactively to patients, teammates, management, physicians, and/or vendors (Village Service Partners) in everyday performance and interactions
- Hospital revenue cycle experience, medical billing, or registration experience managing medium to large-scale operations and projects with medium to high complexity environment including planning, budgeting, resource management, deliverable development, timelines, issues and risks
- Supervisory experience with a strong emphasis on previous Revenue Cycle operations Management
- Related revenue cycle/reimbursement experience
- Read, understand and interpret, analyze, and apply complex regulatory requirements
10
Skills For Director, Revenue Cycle Management Resume
- Help identify areas that need improvement in each hospital's revenue cycle
- Work with the hospital team (CFO, Director of Revenue Cycle, etc.) to formulate a plan of action to facilitate improvement
- Manage a team of 5 analysts at the Corporate level
- Professional Healthcare Revenue Cycle Healthcare provider finance operations or similar service environments required
- Management Healthcare
- Knowledge of healthcare rules/regulations for government and commercial payment
- Ten years experience in healthcare analytics and large complex health system operations management with overall working knowledge of finance, revenue cycle, legal, regulatory and compliance required
- Estimate the financial responsibility of scheduled patients and collect the outstanding obligation before the patient is treated or while they are still in the hospital
List of Typical Responsibilities For a Director, Revenue Cycle Resume
1
Responsibilities For Director, Revenue Cycle Systems Resume
- Evaluates revenue cycle services based on quality, efficiency, cost effectiveness and regulatory compliance; eliminates any duplication or redundancies
- Focus resources on improving interdepartmental processes to improve patient throughput, reduce denials and enhance patient accounting operations
- Ensure all compliance and audit requirements are understood, consistently followed and current in tracking and monitoring requirements
- Accountable and responsible for Patient Access Department, HIM and Information Desk budgets and for monitoring expenses and budget variances
- Anticipate department needs and problem solving ability are imperative
- Oversees development, monitoring and compliance of departmental budget(s)
2
Responsibilities For Senior Director Revenue Cycle Management Resume
- Maintain knowledge of all patient access areas ensuring high productivity and performance
- Maintain properly functioning revenue cycle processes through a cooperative, cross-departmental network
- Perform XClaim and Revenue Recover training in revenue cycle systems for new users and monitor departmental clean-up of work lists
- Monitor high dollar and aging accounts in systems for escalation with departments (DNFB, XClaim, Revenue Recover, RTS)
- Review and ensure departments are reconciling charges on a daily basis
- Follow up on claims and appeals including interaction with payors as needed
3
Responsibilities For Senior Director, Revenue Cycle Resume
- Maintain and enforce all departmental policies while ensuring compliance with all regulatory and accreditation agencies
- Attends monthly CCHCS Patient Access and HIM Enterprise Group meetings
- Integrates responsible department's services with the Hospital's primary functions. Provides leadership that fosters an atmosphere that is conducive to the fulfillment of the Hospital's mission
- Monitors compliance with Department, Hospital, and CCHCS Policies and Procedures
- Keeps Vice President of Finance informed of both Department's activities, needs and problems
4
Responsibilities For Director Revenue Cycle Resume
- Monitors established Patient Access and HIM Goals and Objectives to ensure that measurable standards are met each month
- Works closely with Revenue Enhancement Team to minimize reimbursement loss
- The ability to analyze and evaluate information, exercise own judgment, interpret hospital policies and procedures
- Deploys, monitors and upgrades analytic tools and processes
- Supports accounts receivable and revenue valuation quarterly reviews performed by auditors
- Develops revenue valuation recommendations for management
- Serves as the corporate revenue cycle lead for Ascension Ministries within a given region, managing those Ministries' acute care revenue cycle functions related to Ascension's partnership with Accretive
5
Responsibilities For Senior Director Revenue Cycle Resume
- Steers Ministries' revenue cycle services by guiding innovative, high level approaches for revenue cycle operations, developing strategic revenue cycle partnerships, and driving an overall vision for Ascension's revenue cycle business
- Assesses the impact of revenue cycle operations on Ascension's position in the healthcare provider market; develops innovative approaches to new market competition and/or issues as they arise
- Provide leadership and managerial support to pre-registration, registration, residual collections, bed placement, and insurance eligibility/benefits verification, pre- authorization, community wide scheduling, and financial counseling
- Achieve annual goals of revenue cycle performance
- Work with management and hospital departments to improve processes, increase accuracy, create efficiencies, resolve related issues and achieve overall goals of the department
- Interact with departments and physicians' offices to understand the processes and services they provide, as well as their needs
- Make suggestions for process improvements and develop plans to successfully implement
6
Responsibilities For Director Revenue Cycle Operations Resume
- Participate on revenue cycle team and all other hospital-based teams as required
- Attend monthly Patient Access Management meetings to provide feedback and address open items with local management on revenue cycle activities being completed within the facilities
- Ensures Revenue Cycle meets all financial goals through efficient and effective operations
- Quality improvement and establishment of quality standards and monitors
- Implement and drive organizational policies and best practices
- Drive continuous improvement and efficiencies within the department
- Manage the portion of billing that relates to AR and denials. Knowledge of commercial payer and commercial payment activity and related healthcare terminology, including CPTIV, ICD10 and HCPCS
7
Responsibilities For Director, Revenue Cycle Mangement Resume
- Improve the accuracy of medical coding and clinical documentation performance and processes, thus maximizing payment and supporting quality improvement
- Manage the complexities of change associated with regulatory initiatives (e.g., meaningful use, ICD-10) so that payment from commercial and government insurers are not disrupted
- Eliminate sources of underpayment and overpayment so that hospitals and clinicians are paid accurately the first time and swiftly resolve past mistakes
- Technical flow documentation
- Design and maintenance
- Proactively identifies sources of issues and communicates these to the appropriate parties. In conjunction with the Entity and corporate Revenue Cycle leadership teams, maintains ongoing issues and priority list for Entity and corporate Revenue Cycle. Completes analysis of issues for action, presents this information and assists the Entity implement action plans
8
Responsibilities For Director Revenue Cycle Ops Resume
- Coordinate with peers across the revenue cycle organization, and with related stakeholders, on the management of third-party denials by working with the other onsite Revenue Cycle leaders, Patient Access Services, Middle Revenue Cycle, and Patient Financial Services functions to identify trends and implement denials prevention and recovery programs
- Acts as leadership spokesperson in the absence of the department’s Executive Management as needed
- Drives process improvement initiatives, strategic plan implementations and change management actions to facilitate billing and collections functions ensuring the maximization of revenue. Provides insight, advice and consultation to ensure use of the most appropriate processes and procedures to increase efficiency and effectiveness of the reimbursement function
- Assess the accuracy of billing and payments; address queries from internal and external customers; analyze fluctuations in Fidelis’ reimbursement amounts; drive process improvement to maximize financial results; oversee the collection and analysis of information; summarize trends; prepare special financial reports regarding payments received and outstanding receivables
- Reviews, analyzes and interprets financial data to monitor progress toward established goals; identifies deterrents to success and implements improvements as necessary to enhance efficiencies and results; facilitates effective problem resolution and development of business office goals and objectives. Work alongside financial teammates to meet financial goals
- · Analytical/critical thinking and reasoning skills. Ability to communicate effectively and professionally in written and verbal context. Strong management skills. Knowledgeable of hospital operations and patient flow. Knowledgeable in the use of Microsoft Office applications and other hardware and software programs applicable to Revenue Cycle operations
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