Integrated Medical Services

Receive alerts when this company posts new jobs.

Similar Jobs

Job Details

Revenue Cycle Director

at Integrated Medical Services

Job Description

Integrated Medical Services (IMS) is a physician-led organization united through its providers’ commitment to high-quality, innovative health care. The multi-specialty group has primary care and most specialties well represented throughout the Phoenix metropolitan area and many rural locations.

Job Description

The Revenue Cycle Director is responsible for the overseeing and directing the overall policies, objectives and initiatives of IMS’s revenue cycle management activities.  The Revenue Cycle Director coordinates implementation of services, policies, and programs for IMS practices and assists and advises company leaders about billing office issues and processes.  The Director will work with the Revenue Cycle Manager, Clinic Leadership and Executives in a professional, positive manner to facilitate setting and meeting organizational goals.

 Essential Job Functions

  1. Development of the Billing Office Department
    • Oversee and coordinate revenue enhancement initiatives and business operations across all aspects of the revenue cycle operations team.
    • Establish departmental measurements to monitor Key Performance Indicators (KPI’s) for timeliness and effectiveness of department activities.
    • Advise team on methods of monitoring and improving the effectiveness of collection efforts and maintaining account receivables at specific percentage in 30, 60 and 90 days.
    • Act as a liaison between all providers/clinic leadership and the revenue cycle team in order to promote positive relationships.
    • Prepares periodic reports for management, as necessary or requested, to track strategic goal accomplishment.
    • Develops and administers programs, procedures, and guidelines to help align the workforce with the strategic goals of IMS.
    • Participates in management staff meetings and attends other meetings and seminars.
    • Manages the Billing Office within the established budget including annual planning and develops monthly status reports on specific billing processes.
    • Review and maintain familiarity with payer contracts pertaining to revenue cycle operations. Working on contract negotiations and renewals as needed.
  2. Electronic Healthcare System
    • Thorough understanding of the Revenue Cycle process and of the systems technology to direct the design, testing and implementation of improvements for computer-based systems in support of billing, account maintenance, customer service and claims collection departments.
    • Works with information technology to develop and oversee systems and to ensure timely and accurate implementation and automation of processes.
    • Manages and works with any necessary vendors to ensure the smooth process and required data is maintained and utilized efficiently.
    • Remains current on the specific data requirements as dictated by various government and private insurance carriers and ensures the system/s are appropriately updated.
    • Manage report development to communicate the billing operation effectiveness.
    • Analyze, review, and develop reports necessary for the billing office to ensure IMS goals and guidelines are achieved.
  3. Training and Development
    • Oversight of performance measures and modify them as necessary.
    • Conduct periodic review of the billing service to identify its strengths and weaknesses. Make a recommendation to executive team for maximizing the billing service’s effectiveness and minimizing inefficiencies.
    • Report trends and solutions to account delinquency to the executive team.
  4. Employee Relations
    • Develop policies and procedures throughout the billing operation to standardize operations, communicate expectations, and establish agreed upon outcomes.
    • Partners with Executives to communicate policies, procedures, and programs that impact the practices within IMS.
    • Promotes the IMS accepted employee relations practices necessary to establish a positive employer-employee relationship and promote a high level of employee morale and motivation.
    • Works with Human Resources to conduct investigations when employee complaints or concerns are brought forth.
    • Monitors the implementation of a performance improvement process with non-performing employees.
    • Manages, trains, orients and evaluates performance over assigned personnel. Recommends merit increases, promotions, disciplinary actions.
    • Fosters relationships internally and externally, to include but not limited to practices, IMS departments, vendors, and insurance carriers.
  5. Organization Development
    • Designs, directs, and manages billing office process of organization development that addresses issues such as growth planning, superior workforce development, key employee retention, organization design, and change management.
    • Sets goals for the revenue cycle department on an annual basis for the purpose of contributing to the implementations of strategic goals.
    • Develops core reports to be distributed to practices as necessary to manage the Revenue of each practice and IMS.
    • Develop policies and procedures throughout the billing operation to standardize operations, communicate expectations, and establish agreed upon outcomes.
    • Develop, implement, and maintain measurement and control systems to ensure compliance to established standards of performance.
    • Prepare financial and revenue cycle operational statistic reports as directed.
    • Demonstrates knowledge of, and supports, IMS mission, vision, value statements, standards, policies and procedures, operating instructions, confidentiality standards, and the code of ethical behavior.

Job Requirements:

  1. Financial management, including the ability to analyze data for operations, budgeting, auditing, and forecasting.
  2. Basic accounting knowledge including A/R analysis, staffing and financial reporting skills.
  3. Excellent interpersonal skills, with a demonstrated ability to work with a wide variety of people, both within the system and outside.
  4. Ability to plan, organize and effectively lead multi-disciplinary teams and projects and develop meaningful results within established time-frames.
  5. Working knowledge of electronic billing systems and strong working knowledge of governmental billing requirements and resources.
  6. Demonstrated experience in implementing electronic healthcare systems.
  7. Exceptional verbal and written communication skills in relaying technical information to non-technical advisers.
  8. Demonstrated ability to serve as a successful participant on a management team that provides company leadership and direction.
  9. Demonstrated ability to interact effectively with the peers and subordinates.
  10. Excellent computer skills in a Microsoft Windows environment.
  11. Demonstrates attitude of accessibility and availability.
  12. Must include Excel and skills in database management and record keeping.
  13. General knowledge of various employment laws and practices.
  14. Evidence of the practice of a high level of confidentiality.
  15. Excellent organizational skills.

Education and Experience

Education and Certificates:

  1. Bachelor degree in Health Care, Finance, Business Administration or a related field is required.
  2. Certified Professional Coder (CPC) certification preferred.

Experience:

  1. 5-10 years’ experience required, specifically overall revenue cycle management of a large (50-100+ providers) medical group practice with knowledge of the physician billing and insurance claim follow-up and denial management process.
  2. 5-10 years minimum of direct management experience of a large staff (50-100), knowledge of the health plan websites, CAQH, Intelli App software program, GACCP, licensing boards, NPPS (NPI), Medicare (PECOS), National Provider DB and hospital CVO's preferred