Director, Revenue Cycle Collections, FT Hybrid

University of Maryland Medical System Corporation; Linthicum (MD); On-site; USD 120,000 - 190,000; Full time

Job summary

University of Maryland Medical System Corporation is seeking a Director to lead Hospital and Professional revenue cycle performance optimization, maximizing collections and minimizing uncompensated care. You will oversee the entire process from billing to adjudication, directing a high-functioning collections team and collaborating with leadership to set goals.

The role requires extensive AR/billing knowledge, EPIC system experience, and strong leadership to drive improvements while ensuring

Qualifications

• Bachelor's degree in healthcare, Business Administration, Finance or related field or equivalent industry experience.
• Seven to ten years of progressively responsible supervisory experience in health care administration, quality management, finance, or information systems.
• Experience with billing, accounts receivable processes, and revenue cycle performance improvements.

Responsibilities

• Plan and direct a high functioning collections team that includes Sr. Managers, Managers, and Supervisor levels that support delegation and oversight for multiple service areas and staffing.
• Direct and manage accounts receivable (A/R) to ensure accounts are collected compliantly/appropriately from members, non-members, insurance carriers to include all payer classes to secure appropriate reimbursement.
• Respond to Revenue Cycle issues to promote maximized reimbursement and collections while reducing uncompensated care.
• Collaborate with Revenue Cycle Executive Team to develop department goals and procedures to achieve them.
• Identify and implement methods to automate and streamline the Revenue Cycle Team to meet/exceed goals.
• Review reports to reflect the effectiveness of collection policies and procedures.
• Inform Leadership of changes in third-party reimbursement environment.
• Interview, hire, train, evaluate and, when necessary, discipline subordinate team members.
• Coordinate with Patient Access and Inpatient/Outpatient Offices for smooth billing information flow.
• Oversee daily operating activities and adjust work assignments to maintain optimal AR.
• Maintain knowledge of policies on patient confidentiality and third-party payer regulations.
• Present performance metrics to Executive Leadership with commentary on impact factors.
• Oversee Medicaid Billing and 3808 Process to ensure timely review and turnaround for reimbursement.
• Develop and maintain relationships with Medical System team members, physicians, patients, volunteers and visitors.
• Promote a positive work environment and support staff through coaching and mentoring.

Skills

EPIC system knowledge

Billing and AR expertise

Regulatory/compliance knowledge

Leadership and team management

Verbal and written communication

Education

Bachelor's degree in healthcare, business, finance or related field

Job description

Job Requirements

Under limited supervision of the Senior Director, the Director leads overall strategy and operations for Hospital and Professional revenue cycle performance optimization to maximize collections while minimizing uncompensated care and maintaining the highest levels of patient, physician, and employee satisfaction. This includes management oversight of all business-related functions from the point of billing to overall adjudication of the patient’s accounts.

Primary Responsibilities

• Plan and direct a high functioning collections team that includes Sr. Managers, Managers, and Supervisor levels that support delegation and oversight for multiple service areas and staffing.


• Direct and manage accounts receivable (A/R) to ensure accounts are collected compliantly/appropriately from members, non-members, insurance carriers to include all payer classes to secure appropriate reimbursement.


• Quickly and proactively responds to Revenue Cycle issues to promote maximized reimbursement and collections while reducing uncompensated care to include follow up, collections, denial management, charity care, etc.


• In collaboration with the Revenue Cycle Executive Team, develops goals for the department, and administers procedures to achieve those goals.


• Identifies and implements methods to automate and streamline The Revenue Cycle Team to meet and/or exceed goals.


• Reviews reports to reflect the effectiveness and scope of all collection policies and procedures administered by the department.


• Interacts closely with Leadership to review and/or alter collection policies and procedures to reflect changes in the industry and Medical System that have impact upon the department's goals. Informs Leadership and Teams of any changes in the third-party reimbursement environment.


• Interviews, hires, trains, evaluates and, when necessary, disciplines and discharges of subordinate team members in accordance with established policies.


• Conducts regular meetings to obtain feedback concerning problems, potential problems and agreed-upon solutions. Keeps team members current concerning changes in the third-party payer environment.


• Interacts closely with the Patient Access department and the Inpatient and Outpatient Business Offices to provide a smooth flow of patient billing information through the admission, discharge and billing functions to also include effective communication amongst the areas.


• Oversees the management of daily operating activities of the areas indicated in Job Title and makes necessary adjustments in work assignments to maintain optimal accounts with receivable collections and patient experience.


• Maintains a current knowledge of and ensures compliance with the relevant policies and procedures pertaining to patient confidentiality, patient rights, insurance, and third-party payer regulations.


• As a key member of the organization’s leadership team, actively participates in appropriate administrative and committee meetings to present key performance metrics to Executive Leadership with commentary regarding impact factors, preferably in a structured presentation.


• Direct oversight of the Medicaid Billing and 3808 Process to ensure DSS and Telligen are meeting requirements for timely review and turn around for reimbursement.


• Participates in the professional development activities and maintains professional affiliations within the area of expertise. Reads appropriate trade publications and attends seminars in order to keep informed of impending changes and/or new methods to be used in the receivables management of the Medical System.


• Develops and maintains effective relationships with other Medical System team members, physicians, patients, volunteers and visitors to promote a positive response to the Medical System.


• Promotes a positive work environment and encourages others. Supports staff through coaching, mentoring, and collaboration.


• Performs related duties as required.

Work Experience

• Bachelor's degree in healthcare, Business Administration, Finance or related field related, or equivalent industry experience.


• Seven to ten years of progressively responsible supervisory experience in health care administration, quality management, finance, or information systems.

Knowledge, Skills, & Abilities

• Utilizes and understands the EPIC system and operational capabilities.


• Extensive knowledge of third-party and insurance company operation procedures, regulations and billing requirements, and government reimbursement programs required.


• Thorough understanding of medical information systems for billing and accounts receivable, spreadsheet analysis, and reporting applications is required.


• Demonstrate the ability to accurately assess situations and reach sound and workable solutions using strong reasoning capabilities. Ability to successfully resolve conflict-oriented situations. Demonstrated sensitivity to confidentiality and the political dynamics of an academic medical environment required.


• Ability to successfully perform the responsibilities of the position within a stressful work environment, demonstrating a positive and professional work ethic. Demonstrated ability to oversee, schedule, coordinate and direct project activities, assign work, monitor work, and evaluate performance. Able to act independently without specific instructions in a self-confident and constructive manner.


• Highly effective verbal communication skills are required to work with senior management, executive leadership, and external government agencies, and to direct various projects. Highly effective writing skills are required to compose project-related correspondence and to maintain necessary project records.


• Highly developed organizational skills and interpersonal skills. Demonstrated ability to function in a matrix environment. Demonstrated ability to develop strong relationships with key customers.