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Vice President of Revenue Cycle Management

Company: American Esoteric Laboratories
Location: Austin
Posted on: November 19, 2021

Job Description:

Vice President of Revenue Cycle Management Austin, TX Job Functions, Duties, Responsibilities and Position Qualifications: Job Summary:The Vice President of Revenue Cycle Management provides cross-functional leadership that facilitates an effective operation of the entire end-to-end revenue cycle process. Responsible for oversight of the revenue management cycle to optimize reimbursement and ensure achievement of the company's financial targets. Essential Key Responsibilities:

  • Provide leadership and oversight for the programs, policies, procedures, and operations of end-to-end revenue cycle management functions.
  • Provides oversight of revenue cycle including payer enrollment, charge capture, financial clearinghouse, coding, billing, cash reconciliation and collections of accounts receivable from payers and patients.
  • Directs strategic planning, strategic goals, and objectives in the revenue cycle department.
  • Ensures compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers.
  • Ensures that all payment posting is done in accordance to established contracts and company standards.
  • Assess, identify and define areas of opportunity for reengineering processes to improve revenue cycle management and cash flow
  • Develops and implements standards, processes, controls, and policies and procedures for all billing activities to ensure a timely, correct and appropriate revenue cycle process.
  • Standardizes revenue cycle reporting to include benchmarks and key performance indicators for all phases of the revenue cycle.
  • Requests, prepares and maintains reports on billing, coding, utilization and collection activities.
  • Directs AR Information Management by improving discrete data management, automation and system support to enhance the revenue cycle.
  • Educates management and staff on revenue cycle standards and provide timely feedback of key performance indicators.
  • Charge Master Maintenance in collaboration with the Compliance department
  • Perform audits of the revenue cycle including compliance standards with all state and federal regulations, reconciliation of revenues and vendor performance
  • Maintains up-to-date expertise and knowledge of the healthcare industry including billing laws, rules, regulations, and developments necessary for the organization to make informed business decisions.
    - Works with revenue cycle departments on their processes for charge capture and reconciliation.
  • Monitors the unbilled accounts, works with billing directors to minimize the unbilled accounts.
  • Improves collections by identifying, examining and analyzing patterns of rejections, partial denials, or denials from third party payers and implements change.
  • Directs revenue cycle activities to achieve benchmarks for enrollment holds, charge capture days, claim rejection and denial rates, AR days, collection rate and overall collections.
  • Develops and maintains key working relationships with clients and payers to ensure proper billing/collections while acting as an escalation and expert knowledge resource.
  • Proactively identifies reimbursement opportunities and outliers for payer and patient collection issues within all markets. Compile relevant data and reports in support of Managed Care's communication and negotiation with third party payers.
  • Collaboration with Managed Care, IT and Business Intelligence groups to ensure coordinated structure and review to maximize reimbursement levels
  • Maximizes the use of available technologies to insure that all performed procedures are reconciled to billed claims, improve revenue cycle workflow and maximize collections.
  • Monitors and coordinates month end closing procedures with the Vice President & Finance Director within the required time frame.
  • Maintains strictest confidentiality.
  • Complies with all State, Federal, professional regulations as well as company and departmental rules, polices, and procedural manuals.
  • Adherence to State Regulations, HIPAA, Safety and OSHA Regulations.
  • Performs other duties as assigned. Education/Licensure/Certification:
    • Bachelor's Degree in Accounting, Finance, Business or Healthcare Administration
    • Master's degree in Business Administrations (MBA) strongly preferredExperience / Requirements:
      • Minimum of at least ten (10) years' experience in the healthcare industry, including five (5) years managing employees in the revenue cycle department
      • Experience in high volume, clinical laboratory/high volume ancillary service provider revenue cycle management preferred
      • Experience with all national correct coding, regulatory billing, and reimbursement methodologies and legislative requirements (ie: NCCI, MUE, CMS & AMA Guidelines, CARES, OIG, etc)Equipment:
        • Computer, computer programs, billing information systems, and general office equipment. Knowledge/Skills/Abilities:
          • Ability to work in a fast paced environment with heavy AR Management
          • Able to respond to change quickly and generate creative ideas and solutions to emerging business changes
          • Knowledge of Commercial, Medicare, Medicaid, and Managed Care contracting, billing and reimbursement methodologies.--
          • Knowledge of governing regulations and standards related to healthcare billing, collections, and client satisfaction
          • Knowledge of all elements of the Revenue Cycle, including: revenue recognition and collection of services billed, charge capture and control, cash collections and controls, minimizing bad debt percentage, coding accuracy of professional, technical and ancillary services, call wait time and call abandonment and client satisfaction ratings.
          • Excellent in areas of critical thinking, analytical skills and interpersonal relationships.
          • Excellent written, verbal, and presentation skills.
          • Excellent problem solving and continuous improvement skills.
          • Ability to analyze, assimilate and proactively anticipate factors with potential organizational receivables and reimbursement impact.
          • Ability to establish and maintain positive relationships with employees, physicians, vendors, clients, and external agencies.Environmental Working Conditions:
            • Office Setting; with minimal time in a laboratory setting; exposure to communicable diseases, toxic substances, blood borne pathogens and chemical hazards.
            • TravelPhysical Requirements:
              • Physical demands are representative of those that must be met by an employee to successfully perform the essential functions of this job. The employee is occasionally required to stand; walk; sit; use hands to finger; handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; taste or smell. The employee must occasionally lift and/or move up to 5 pounds. Specific vision abilities required by the job include close vision, distance vision, and the ability to focus. Requires visual acuity and normal color perception.HIPAA/PHI Security Level: HIGH (Low, Medium, or High)Security access levels of Protected Health Information (PHI), as necessary to perform essential key responsibilities of the position (access, utilize, disclose, store, and/ or dispose of PHI):1. Low -information access is of general nature representing summary type data rather than specific identifiable demographic or sensitive data.2. Medium - information access is specific to an individual's demographics and service information (type of service, services received, dates of service, and provider of service).3. High - information access is detailed and sensitive to an individual's demographics, service information, and personal medical history (past/present medical conditions, specifics of medical diagnosis or tests, treatment plans, and family history).All job requirements listed indicate the minimum level of education, knowledge, skills and/or experience necessary to proficiently perform the job. This job description is not to be construed as an exhaustive statement of duties, responsibilities or requirements. Employees will be required to perform any other job-related duties assigned by their supervisor, subject to reasonable accommodations.Scheduled Weekly Hours:40Work Shift:Company:Sonic Healthcare USA, IncSonic Healthcare USA provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Full time REQ-011388 About Us About Sonic Healthcare USA Sonic Healthcare USA is a subsidiary of Sonic Healthcare Limited, one of the world's largest medical diagnostic companies, providing laboratory services to medical practitioners, hospitals and community health services, with operations in eight countries, on three continents and providing care to over 100 million patients each year. Sonic Healthcare USA is a leading provider of state-of-the-art laboratory services and pathology practices throughout the USA with eight operating divisions and nearly eight thousand US- based employees, 330 Pathologists and serving over 30 million patients per year. Sonic Healthcare USA operates under a federated business model that emphasizes medical leadership and community-based testing services to provide outstanding quality and service to the doctors and patients that they serve. For more information, visit the Sonic Healthcare website at www.sonichealthcareusa.com.

Keywords: American Esoteric Laboratories, Austin , Vice President of Revenue Cycle Management, Executive , Austin, Texas

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