Director, Business Optimization

Columbia University Irving Medical Center; New York (NY); On-site; USD 160,000 - 180,000; Full time

Job summary

The Director of Business Optimization at Columbia University Irving Medical Center will partner with the Department Administrator, CFO, and revenue teams to optimize patient billing workflows, maximize revenue, and minimize errors while improving the patient experience.

This leadership role requires expertise in revenue cycle management, payer contracting, Epic systems, and data-driven process improvements, with a proven ability to reduce denials and elevate efficiency across the department.

Qualifications

• Bachelor’s degree or equivalent; five years of related experience.
• Strong knowledge of revenue cycle, reimbursement and payer contracting.
• Proficient in databases, BI tools, and spreadsheet applications.
• Excellent written and oral communication skills.
• Ability to work independently and collaboratively, with multitasking ability.

Responsibilities

• Manage department staff handling charge review edits, reports, estimates and enrollment tasks.
• Coordinate new programs with FRO staff and department liaison for revenue collection and denials.
• Attend payer meetings on behalf of the department.
• Monitor revenue cycle performance, write-offs, denials, and high-dollar charges.
• Update DRM documentation and provide staff training as needed.
• Monitor work queues to prevent revenue delays in coding/claims.
• Collaborate to achieve revenue targets and implement Epic initiatives.
• Interpret payer contracts with contracting, compliance, and finance.
• Oversee Epic SER provider records accuracy and payer enrollment dates.
• Lead annual CPT/ASA code updates for Epic dictionary mapping.
• Act as revenue cycle SME for the department; identify workflow issues in Epic PB Transaction Inquiry.
• Ensure HIPAA and billing compliance; perform general admin duties.

Skills

Database

Business Intelligence

Spreadsheets

Communication

Independent & Collaborative Work

Education

Bachelor’s degree or equivalent

Master’s degree (preferred)

Tools

Epic

Job description

• Job Type: Officer of Administration
• Bargaining Unit:
• Regular/Temporary: Regular
• End Date if Temporary:
• Hours Per Week: 35
• Standard Work Schedule:
• Building:
• Salary Range: $160,000 - $180,000

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to departmental budgets, qualifications, experience, education, licenses, specialty, and training. The above hiring range represents the University's good faith and reasonable estimate of the range of possible compensation at the time of posting.

Position Summary

The Director of Business Optimization will work closely with the Department Administrator, CFO, and department coding and revenue teams to ensure that all patient billing activities are functioning optimally to maximize revenue, minimize errors and improve the overall patient experience.

Responsibilities

• Manage department staff responsible for processing charge review edits, ad hoc faculty practice reporting, good faith estimates, client accounts and provide enrollment tasks assigned to the department.
• Coordinate all new programs and procedures with FRO staff and Department Liaison so that staff is fully trained to collect revenue and address denials.
• Attend scheduled payer meetings on behalf of the department.
• In collaboration with the Department Administrator, provide ongoing monitoring and analysis of centralized revenue cycle functions, including assessment of CRO performance in the areas of write-offs/adjustments, denials, DAR, charge corrections, evaluation of high dollar charges and accounts, and submission of payer projects.
• Maintain and update department DRM documentation for CRO revenue cycle staff and provide training when needed.
• Closely monitor work queues to address issues that are preventing coding or claim submission resulting in revenue delays.
• Collaborate with CRO/Liaison to achieve ColumbiaDoctors revenue cycle targets and implement new Epic initiatives and upgrades
• Partner with contracting, compliance, and finance to interpret payer contracts and operationalize contract terms, including revenue of Anesthesia Addenda for current negotiations.
• Provide ongoing oversight and routine audit of Epic SER provider records to ensure accuracy, compliance, alignment with payer enrollment, and effective dates.
• Provide leadership on annual national published updates to CPT/ASA codes to ensure accurate Epic dictionary mapping of ASAs to CPTs required for coding and claim submission.
• Work as a subject matter expert to the department for all revenue cycle processes.
• Identify workflow issues within Epic PB Transaction Inquiry that are non-compliant with expected outcomes and can affect revenue collection.Conform to all applicable HIPAA, billing compliance, and other pertinent regulations.
• Perform general administrative functions, and related duties and responsibilities as assigned/requested.

Minimum Qualifications

• Bachelor’s degree or equivalent in education and experience, plus a minimum of five years of related experience.
• Thorough knowledge of project improvement management processes, the healthcare industry revenue cycle, reimbursement and payer contracting strategies and trends.
• Proficient in database, business intelligence and spreadsheet applications.
• Ability to communicate effectively in both oral and written form.
• Ability to work independently and collaboratively, with follow-through and to handle multiple tasks simultaneously.

Preferred Qualifications

• Master’s degree.
• Seven (7) years plus experience in health care and revenue cycle.
• Epic experience and prior supervisory experience.

Equal Opportunity Employer / Disability / Veteran

Columbia University is committed to the hiring of qualified local residents.