System Director, Revenue Cycle Operations

Job Summary:

The System Director of Revenue Cycle Operations is responsible for advising and assisting senior leadership on all areas of revenue cycle operations, serving as the primary contact between the system and the system’s designated outsourced revenue cycle partner. The scope of this work will include:

Covenant Health acute care hospitals (primary) Covenant Health affiliated physician practices (primary) Covenant Health assisted living, independent living, and skilled nursing facilities (advisor)

Areas of end-to-end revenue cycle operations responsibility will include:

• Patient Scheduling
• Centralized Call Center
• Registration
• Insurance Verification
• Insurance Authorization
• Patient Financial Services/Financial Counseling
• Financial Assistance and Charity Care
• Facility Charge Description Master(s)
• Charge Capturing and Revenue Integrity
• Health Information Management
• Clinical Coding
• Patient Requests for Medical Records
• Clinical Documentation Improvement
• Medicaid Eligibility
• Collections and Reimbursement
• Revenue Cycle Policies and Procedures
• Regulatory Compliance and Patient Privacy (HIPAA)
• Patient Engagement

Critical responsibilities include serving as a conduit of communication between Covenant Health facilities and our outsourced revenue cycle partner to achieve annual and periodic goals for defined key performance indicators (KPIs) of revenue cycle performance, and for the organization’s overall financial performance.

Essential Duties and Responsibilities

• Supports and promotes the mission and values of Covenant Health and the Catholic Health Ministry.
• Collaborates effectively on all levels to ensure a cohesive and productive working relationship with all revenue cycle stakeholders.
• Coordinates and monitors successful operation of all aspects of Patient Access, Health Information Management, Clinical Documentation Improvement, and Business Services functions between Covenant Health facilities and our outsourced revenue cycle partner.
• Understanding of all aspects of contractual agreement between Covenant and outsourced revenue cycle partner, making recommendations for revisions and enhancements as identified.
• Ensures leading practice results, process improvement, and optimization to achieve best practices that positively impact net revenue and cash flow performance.
• Identify and improve areas for greater consistency and standardization to ensure that processes and workflows are effectively and efficiently handled on the front end, through service delivery, and at the back end.
• Works closely with the Covenant Health and outsourced revenue cycle partner key leaders to implement and maintain sophisticated systems and processes that will enhance the revenue cycle operations.
• Manages budget and variance monitoring for outsourced revenue cycle partner. Ensures compliance with and works to mitigate departures from vendor service level agreements.
• Analyzes and communicates performance of healthcare insurance plans and payers through tracking of key performance indicators to make informed decisions, identify issues in claims processing and ensure fair terms and faster payment.
• Interacts with co-workers, vendors, visitors, and other staff consistent with the mission and values of Covenant Health.
• Conducts routine site visits to facilities, as needed.

Other Functions and Competencies

• Operational Review/Process Improvement – review and assess the current revenue cycle infrastructure, processes, and workflows to continue the organization’s progress toward enhanced accountability and consistency, especially with regard to facility charge capture and reconciliation.
• Develop initiatives - increase operational rigor, encourage industry best practices, and improve standardization across the Covenant Health with the objective of promoting greater operational efficiencies.
• Optimize Financial Performance - Working with outsourced revenue cycle partner, various departments and payers at hospitals, minimize revenue denials and develop root cause, proactive resolutions to prevent denials. Ensure continuous refinement of performance metrics to improve and increase patient revenue.
• Relationship Development/Education – work in close collaboration with Covenant Health facilities to promote and implement consistent standards and industry best practices. Breaks down barriers/opens communication among and between Covenant Health facilities and revenue cycle outsourcing partner.
• Liaison – have the energy, persistence, and sense of ownership to manage the revenue cycle process from end-to-end and be the key liaison to implement revenue cycle optimization, processes, and workflows, working with stakeholders throughout the system, including Information Technology, Case Management, Ancillary Services, Operations, Finance, Managed Care and Provider Practices.

Job Requirements

• Bachelor’s Degree in related field such as Business Administration, Healthcare Management, etc.
• Minimum of ten years of related experience in healthcare management or revenue cycle operations.

• Must have the ability to use standard office equipment and have basic computer skills.
• Must have the ability to interpret and apply standard procedures.
• Must have the ability to handle confidential information.
• Must possess the ability to make independent decisions and problem solve as appropriate.
• Must have the ability to plan, organize, develop, implement, and interpret goals, objectives, policies, procedures of all revenue cycle operations.
• Must possess the ability to positively interact with personnel, patients, residents, family members, visitors, government agencies, and the general public.
• Must have strong knowledge of the reimbursement process and regulations.

An equivalent combination of education and experience which provides proficiency in the areas of responsibility listed above may be substituted for the above education and experience requirements.

Covenant Health Mission Statement

We are a Catholic health ministry, providing healing and care for the whole person, in service to all in our communities.

Our Core Values:

•Compassion

We show respect, caring and sensitivity towards all, honoring the dignity of each person, especially the poor, vulnerable and suffering.

•Integrity

We promote justice and ethical behavior, and responsibly steward our human, financial and environmental resources.

•Collaboration

We work in partnership, dialogue and shared purpose to create healthy communities.

•Excellence

We deliver all services with the highest level of quality, while seeking creative innovation.

Applicants, employees and former employees are protected from employment discrimination based on race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age (40 or older), disability, and genetic information (including family medical history).

Comp Range:

Rate of pay displayed reflects the beginning of the pay scale. At the time of an offer, determination of your offer will reflect your skills and experience as it relates to the position.