VP of Revenue Cycle
Company: DeKalb Health
Location: Little Rock
Posted on: January 26, 2023
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Job Description:
JOB SUMMARY: The Vice President of Revenue Cycle is responsible
for the leadership, integration, and standardization of all Revenue
Cycle departments within the organization. Partnering with all
leaders and physicians, the VP of Revenue Cycle will implement
processes that maximize the prompt seamless acceptance of patients
within all levels of care at CARTI.Areas of responsibility include
Pre-Certification, Registration, Charge Capture, Billing, Coding,
Claims Submission and Aging, Collections, Central Referral Office,
Switchboard, Pre-Registration, Patient Access, Patient and Support
Services, Financial Advocacy and Medical Records. Requirements
EDUCATION, CERTIFICATION, LICENSURE and REGISTRATION:
1. Bachelor's degree with an emphasis in business, accounting, or
healthcare administrationEXPERIENCE, KNOWLEDGE, SKILLS, and
ABILITIES:
1. Minimum 10 years' progressive leadership in healthcare financial
supervisory roles.
2. Minimum 10 years' clinic or hospital Patient Access
experience.
3. Minimum 10 years' experience with EMR, billing, patient
accounting and registration systems.
4. Previous experience with system conversions, system
integrations.
5. Previous experience in acquisitions, integrations of health care
systems and EMRs.
6. Previous experience with computer spreadsheet and data
processing programs.
7. Knowledge of Medicare and Medicaid rules and regulations.
8. Must be outcomes driven, as a valuable team member, always
putting the team above the individual.
9. Must be able to manage multiple projects and handle potentially
stressful situations, as well as must always work as collaborative
team member with other CARTI leaders and team members.
10. Must be able to demonstrate and communicates the mission,
ethics, and goals of CARTI.
11. Must be a proven innovator, given current economic health care
environment.
12. Enthusiastic, self-motivated, and committed to excellence.
Summary JOB SPECIFIC DUTIES AND RESPONSIBILITIES:
1. Hires, trains, supervises, evaluates, and assists the Revenue
Cycle leaders. Is responsible for oversight of leaders' duties and
responsibilities.
2. Establishes department objectives, policies and procedures and
evaluates effectiveness. Emphasizes teamwork and encourages front
line staff involvement in providing input.
3. Follows-up on Medicare and Medicare replacement plan accounts,
including research, patient contact, obtaining reviews, rebilling,
no-pay or balance after billing and appeals.
4. Responsible for Medicare credit balance accounts, refunding
Medicare, Medicaid other carriers when necessary reports.
Responsible for Medicare Secondary Payer (MSP) education and
carrier updates regarding refunds.
5. Reviews and approves refund requests for patient accounts at
determined dollar amount.
6. Prepares and manages budgets for Revenue Cycle teams.
7. Optimizes cash collections within the rules and regulations
governing health care accounts receivable.
8. Keeps current on all regulatory changes regarding accounts
receivable and health information management and communicates and
implements changes and training when necessary. Ensures compliance
within department with all CMS regulations and audit
requirements.
9. Reviews accounts from internal collection efforts monthly for
collections action (e.g., collection agency, litigation, etc.)
Reviewing with Assistant CFO when appropriate.
10. Maintains CARTIs charge master, including price changes/edits,
new charge codes, description changes, CPT/HCPCS applications,
annual price increases and revenue code applications. Works with
managers to ensure their charges and CPT/HCPCS are correct.
Oversees audits after all changes to ensure testing did not miss
anything.
11. Oversees administration and maintenance of electronic billing
and remittance software. Ensuring consolidation of EMR and billing
systems to a standardized CARTI system process.
12. Coordinates testing of updates to relevant computer module and
communicates changes to personnel and trains when necessary.
13. Oversees daily processing and month end closing of systems.
Provides daily, weekly, and monthly summary.
14. Maintains dictionaries ensuring that bills, statements,
reports, reminders etc. print correctly and accurately and that
changes and new entries flow correctly.
15. Maintains certain MIS dictionaries, such as the insurance
dictionary ensuring that the changes and/or creation of new entries
flow through and are entered on all other coordinating
dictionaries.
16. Responds to audit requests by insurance companies and
participates as needed in audits and surveys performed by
regulatory agencies.
17. Supports report development to provide patient
account/financial services and other areas reports as requested to
ensure effective audit and review and to instill the impact of
everyone's contributions.
18. Assures confidentiality for all patient/customer information as
per CARTI policy.
19. Supports and demonstrates CARTI's strong commitment to the
highest standards of business and professional ethics. Encourages
team member engagement in this effort.
20. Participates in appropriate CARTI committees as assigned.
21. Handles special projects as assigned.
22. Directs counsel to patients as to financial responsibilities;
identifies financial options available and assists patients
whenever possible.
23. Maintains good public relations with physician offices, public
agencies, and insurance companies.
24. Oversees patient related correspondence and complaints.
25. Provides input and review of contracts for carriers and
third-party payers and makes recommendations.
26. Completes annual performance appraisals for direct reports
following CARTI procedure.
27. Completes progressive disciplinary reports and deliver
counseling as needed for direct reports per CARTI policy.
28. Participates in continuing education/training activities
including monthly online training.
29. Demonstrates ability to handle emergency situations in a
prompt, precise, and professional manner.
30. Demonstrates and communicates the mission, ethics, and goals of
CARTI in day-to-day communications and actions. SUPERVISORY
RESPONSIBILITY: Revenue Cycle (including Patient Services, Patient
Access, Billing, Coding, Collections, Precertification, Medical
Records, and Cancer Registry.)
Keywords: DeKalb Health, Little Rock , VP of Revenue Cycle, Executive , Little Rock, Arkansas
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