Vice President - Revenue Cycle Management

Nashville, TN

Post Date: 07/24/2018 Job ID: 35959 Industry: General

Job description

Donovan & Watkins is partnered with an amazing company with a mission in the Nashville, TN area. They are seeking a Vice President of Revenue Cycle Management to lead the process of developing, implementing and monitoring the processes of the billing functions encompassing the management of information flow from source at the delivery sites through to billing and cash collection, essentially from order/payer approval to cash.

 

The VP RCM will also ensure that the revenue cycle team is viewed as a strong partner cross-functionally throughout the organization and will proactively build collaborative relationships across the company to include effective partnership with field and corporate personnel and the COO and his direct reports and other executives responsible for Intake, Information Systems and Finance.  

 

Responsibilities

  • Manage what is now largely an “out of network” billing operation where insurance pays the patient to one which will transition over time to an “in network” model.
  • Experience transitioning and integrating billing operations from acquired entities and the nuances of morphing from essentially commercial and private pay to Government reimbursement.
  • Formulate goals and objectives for directing reimbursement and billing and oversee he third party, governmental, insurance and self-pay functions of billing and collection of accounts receivable.
  • Keep abreast of all reimbursement billing issues, trends, and procedures of third party, private insurance, managed care and Medicaid to optimize reimbursement.
  • Insure the company maximization of reimbursement from and compliance with all regulations and contracts with respect to reimbursement of governmental payers, courts of law, contracting entities, and other third-party payers.
  • Interact effectively and work closely with third party payers, insurers and the company’s general managers and department staff in the proper development of and adherence to billing, cash collection and accounts receivable policies and practices.
  • Maintain effective communication between corporate and the field offices with respect to billing, reimbursement, and cash collection issues.
  • Establish appropriate procedures for follow-up on third party approvals and billing.
  • Lead procedure design and maintenance of an Operations Manual which shall include written instructions for the following functions: billing and follow-up, internal collections, credit extension, cashiering, collection agencies, outside billing agencies, computer operations, bad debt and administrative write-offs.
  • Ensure the timely and accurate production and distribution of patient bills and statements. Ensure that all patients’ questions and concerns are addressed in a professional and timely manner and that write-offs are processed and accounted for in a manner consistent with the company’s policy. Accountable for patient satisfaction.
  • Establish operational processes and build a highly motivated team to transform reimbursement functions into best practice operations for: billings, collections, cash postings.
  • Direct operations to improve productivity and the customer experience.
  • Establish the necessary process improvement for creating change that focus on continuous, sustainable improvement that will ultimately take costs out of the system, improve coordination between the intake and reimbursement functions, thus increasing collections and reducing DSO.
  • Embrace continuous quality improvement, lean and/or six sigma protocols for process re-engineering to improve operating performance.      
  • Establish effective control and monitoring over all aspects of the reimbursement function from intake to cash including regular reporting of key operating indicators.            
  • Keep abreast of reimbursement billing issues, trends, and procedures of third party, private insurance, managed care, Medicare and Medicaid to maximize reimbursement processes.              
  • Establish appropriate procedures for follow-up on third party approvals and billing.
  • Oversee or review preparation of monthly department reports on the activities of the RM including productivity, cash collections, status of accounts receivable and unbilled accounts, budget variances.
  • Identify and develop key financial and operational performance ratios/measures against which the Department’s performance can be measured.
  • Ensure effective retention of long term employees and the selection, motivation, development, empowerment, coaching and advancement of management and support personnel. Retain and incent A players, develop B players and replace others as necessary.


Education/Certifications

A BS in operations management, finance, business administration or related field is required; a graduate degree and Black Belt Six Sigma certification in process improvement highly desired.

 

Qualifications

  • Firm understanding of third party contracting terms with respect to Medicare, Medicaid, HMOs, PPOs, and a thorough knowledge of third party billing and reimbursement and understanding of the challenges of out of network “pay the patient” collections.
  • Extensive experience and successful track record in process re-engineering for large scale, high volume call center, claims processing, billing center, operations center, or a transactions enterprise in healthcare services or health insurance.
  • Demonstrated success in managing a large scale, high volume, complex billing and collecting operation and integrating same via acquisitions.
  • Demonstrated track record of decreasing receivables and increasing cash collections while still managing to meet the needs and expectations of the company’s stakeholders in a customer friendly manner.
  • The technical knowledge and managerial skill required to plan, direct and control the affairs of a large, complex billing and collecting function.
  • Embrace continuous quality improvement (CQI) and process re-engineering as key tolls in the improvement of operating performance.
Donovan & Watkins, a Brand of BG Staffing, Inc. (NYSE American: BGSF), delivers the just-in-time talent that organizations need to effectively compete in the modern business landscape. Donovan & Watkins matches critical talent in the Finance & Accounting, Engineering, Legal, Administrative & Clerical and Human Resources fields to a diverse range of clients and client needs. To learn more about our services, visit www.donwat.com.

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