Director, Revenue Cycle Resume Samples

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E Casper

Elnora

Casper

8808 Angela Forges

Chicago

+1 (555) 296 6078

8808 Angela Forges

Chicago

Phone

p +1 (555) 296 6078

Experience Experience

Dallas, TX

Director, Revenue Cycle

Dallas, TX

Bogan and Sons

Dallas, TX

Director, Revenue Cycle

Works collaboratively with other departments/senior leadership to identify, install & manage revenue performance improvement initiatives
Measure & manage staff performance/productivity and employment standards
Providing strategic analysis/assessments for our clients resulting in long term RCM transformational work
A team player; a highly collaborative, team oriented process. Leads development of opportunities and management of team resources to grow the business
Provide analysis and data driven recommendations to senior management
Mentors, develops and coaches new and existing staff
Contribute to the compliance with, and development and updating of, department standard operation policies and procedures by

New York, NY

Director, Revenue Cycle Systems

New York, NY

Luettgen Group

New York, NY

Director, Revenue Cycle Systems

Upholds the values and mission of the Tandem Hospital Partners family
Implemented Hospital and Professional Billing Revenue Cycle Systems
Subject Matter Expert in central billing office and build of revenue cycle applications utilized across the organization
Documents and supports the development and refinement revenue cycle workflows (patient access, insurance verification, charge capture, payment posting, self-pay and patient follow-up management)
Optimization, auditing, and setup of work queues for charge capture reconciliation, denial management, clearinghouse, claims management, and payment posting
Ensure the integrity of the Revenue Cycle Systems databases and Master File and Dictionary Configuration
Participate in audit and execute recommendations for improvement of revenue cycle systems

present

Boston, MA

Director, Revenue Cycle Management

Boston, MA

Hirthe and Sons

present

Boston, MA

Director, Revenue Cycle Management

present

Perform other duties as assigned
Mentor employees, conduct performance evaluations, counsel and provide corrective actions to assigned personnel, and work to facilitate individual and team development that drives positive results. Champion affirmative action efforts in all aspects of employment, including but not limited to staffing, training, and promotions. Responsible for compliance with and enforcement of company/department policies and procedures
Develop in-depth intimacy with RCM functions and operations, including the flow of trip ticket inventory, cash receipts and write-off patterns. (By day/week of month, typical problems and issues)
Work closely with AMR’s Arizona VPO, Regional Directors (RD) and other members of Operations, as well as other departments within AMR, to convey issues and propose solutions that will improve efficiencies, and/or reduce costs
Monitor and manage labor costs, inventory levels and production planning for designated departments. Optimize productivity while avoiding unnecessary costs such as excess overtime
Lead initiatives to develop new approaches to streamline existing processes, reorganize work, implement new technologies, and improve resource utilization, with a focus on best cost methods
Establish and maintain open communications with contract facility customers. Monitor key performance indicators and collections goals, resolve billing issues and ensure timely payments

Education Education

Bachelor’s Degree in Accounting

Brigham Young University

Bachelor’s Degree in Accounting

Skills Skills

Excellent knowledge of revenue cycle and other healthcare financial performance metrics
Working knowledge of Microsoft Word, Excel (including pivot tables), PowerPoint and Outlook
Ability to foster open communication, team build, and encourage and maintain team morale
Ability to actively participate in budget development and carry responsibility for achievement of budget targets
Extensive knowledge of the healthcare professional revenue cycle environment, application of strategic AR workflow and a strong understanding of medical billing principles
Ability to perform and complete projects in a timely manner with minimal supervision in a fast paced environment
Extensive knowledge of AR billing systems and utility management as it relates to production and system reporting
Hospital information systems, including data stored and prominent functions which occur in the following departments( Admissions, Medical Records, Order Entry, Discharge Planning, Patient Accounting)
Ability to influence key stakeholders at various organizational levels
Strong leadership skills and commitment to a team approach; both direct and indirect reports

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Director, Revenue Cycle Resume Examples & Samples

Develop and define department goals, procedures and objectives. Develop and monitor revenue cycle performance metrics to drive continuous improvement efforts in all areas of the revenue cycle providing regular updates to senior management to ensure prompt attention to areas of concern
Master’s Degree in Business or Health Administration ideal
Extensive knowledge of medical reimbursement, billing, coding and compliance regulations is required
7 + years leadership experience with a minimum of 5 years leadership experience in Revenue Cycle Management / Claims Management / experience within a Clinical / Anatomic Laboratory or provider organization
Experience managing staff of 25+ employees ideal
Extensive knowledge of the revenue cycle management function and have in-depth knowledge of billing processes to include, but not limited to: Billing Data Entry, Billing Exception Processing, Claims Submission (837 electronic claim submissions), Clearinghouse Process, Remittance / Cash Application (835 electronic remittance), Cash Collections, Accounts Receivable Management, and Appeal Processes
Knowledge of out of network reimbursement techniques
Proven ability to work well with and influence peers, sales teams, and management
Experience presenting to and working directly with C-level executives and work team

Sales Director, Revenue Cycle Resume Examples & Samples

5+ years selling Revenue Cycle software products and services to hospitals
Experience selling to C-suite and other hospital executives including Director of Patient Services, VP of Revenue Cycle and CFO
Demonstrated track record of exceeding annual sales quotas
Experience selling new business
Demonstrated understanding of hospital revenue cycle concepts
Experience selling to acute care hospitals
Experience with Salesforce.com
Knowledge of strategies for hospitals
Knowledge of sales territory management
Good negotiation, conflict management & customer service skills
Ability to manage multiple, diverse projects and sales events simultaneously
Knowledge of current information systems technology and of healthcare industry and trends
Strategic sales account planning skills
Ability to demonstrate consistent closing techniques throughout the sales cycle

Regional Director, Revenue Cycle Resume Examples & Samples

1)____________________________________________________________________________________
Directs the operational performance and overall management of the Regional Business Office (RBO) at the regional level
Ensures achievement of business objectives, including meeting company DSO and AR key performance metric standards
Implements and monitors adherence to company Reimbursement policies and procedures. Effective use of MSH and practice resources to drive optimal revenue cycle outcomes for the practices
2)___________________________________________________________________________
Directs, with AR Director & through site administrators, front office functions including insurance verification, patient registration, financial counseling, scheduling, charge entry and medical records
Provides feedback and works directly with AR Director & site administrators to develop and implement action plans for improving business related functions for practice sites
Works directly with AR Director & sites to identify problem payers
Coordinates with sites and Managed Care to develop and implement action plans to resolve AR issues
Identifies and plans strategies to improve revenue cycle processes and procedures, including supporting improvement of revenue cycle enabling technologies
Oversight of change management process to include mapping out of revenue cycle best practice workflow updates to ensure all recommendations are successfully implemented
Manage revenue cycle projects with communication to key stakeholders and ensuring success in project timeline and execution
3)____________________________________________________________________________________
Directs physician participation processes to ensure physicians are credentialed in a timely manner and front office is notified of changes in participation
Provides ongoing reports and feedback to physician leadership, the State Controller and Executive Director regarding overall revenue cycle key performance metrics and business related functions at both RBO and practice locations
Participates in monthly practice operation meetings and Joint Policy Boards to provide data and feedback to physicians on business related functions and overall AR management. Prepares regular and ad-hoc reports for JPB and practice management use
Maintains and manages budget allocations back to the practices in the consolidated arrangement including managing annual true-ups for the practices in this arrangement
4)____________________________________________________________________________________
Directs the maintenance of computer master parameters including electronic coding and charge files. Directly supervises Directors of Operations and indirect all regional business and supervisory staff, directs through site administrators, the front office management staff
Prepares budget and goals for the Regional Business Office and maintains P& L accountability for the regional RBO operations including meeting annual budget requirements
5)____________________________________________________________________________________
May be directly responsible for managed care functions including strategy development, contract review, negotiation and administration, reporting and payer relations
At least twelve (12) years of Revenue Cycle Management experience required
At least four (4) years project management or supervisory experience required
At least five (5) years supervisory experience coaching, developing, and managing staff
At least (5) years board level meeting experience
Analytic skills essential to identify opportunities to improve revenue cycle management
Knowledge of revenue cycle operations processes
Billing system platform experience (esp. Centricity strongly preferred)
Influencing skills of senior leaders to gain acceptance of best practices
Physician interaction (preferably in a community setting)
Proficiency in Microsoft Office (Outlook, Excel, Word, and PowerPoint) required
Oncology billing including medical & radiation oncology, diagnostic imaging, lab, etc. preferred
Previous experience managing a RBO, CBO or Medical Billing Office, a plus
Bachelor’s degree in Business or Healthcare Administration, highly desired
Master’s degree, a plus

Director, Revenue Cycle Management Resume Examples & Samples

10+ years prior management experience in patient accounting for a large, multi-specialty medical group
Demonstrated commitment to quality and customer service to both internal and external clients
Extensive knowledge and experience in project management with an emphasis in patient accounting system development
Knowledge and experience in contracting and payment mechanisms
Ability to lead large operational departments in a matrix environment
In-depth background in Patient Accounting Management, Patient Accounting Systems Development and Project management

Director Revenue Cycle Resume Examples & Samples

Serves as an expert consultant to senior leadership on major and highly complex issues with strategic importance. Collaborates with TPMG, Health Plan, local and regional leadership, colleagues and subordinates to improve the level and quality of revenue cycle decisions that have financial, legal and regulatory implications to the organization. Works in partnership with local and regional leaders of operating units to identify new ways to enhance financial products and services. Partners with organizational leaders to ensure that operations and processes remain consistent and emulate best practices. Analyzes issues to develop recommendations related to resource requirements in order to achieve desired outcomes
Facilitates compliance with administrative/legal requirements and governmental regulations as they relate to revenue cycle operations. Monitors work unit compliance with internal controls and develops remediation plans to address identified control weaknesses. Accountable for revenue cycle data quality monitoring and related training. Ensures all practices relating to the acquisition and maintenance of information comply with federal, state regulations, policies, and procedures
Minimum of five (5) years of experience directing Revenue Cycle activities for a large hospital, medical group, and/or healthcare system
Minimum of five (5) years of relevant management experience

Director Revenue Cycle Ops Resume Examples & Samples

Plan, organize and direct through management and supervisory personnel the cost effective operations of the departments responsible for all patient/third party billing, patient registration, admitting, ED check-out,
Minimum five (5) years of experience required managing a staff of professionals in the revenue cycle environment
Experience preferably in an acute care hospital

Director, Revenue Cycle Resume Examples & Samples

Provides the overall direction and oversight of functional area in support of departmental initiatives and goals. Leads the conceptual design and development of action plans that drive strategic initiatives. Actively monitors operational performance to anticipate and meet the needs of leadership. Drives for changes in work products and processes that will improve functional area efficiencies and effectiveness. Fosters a positive and proactive work environment, emphasizing respect for individuals, high standards of quality, customer service, innovation and team work. Fosters strong results orientation within functional area by motivating staff and holding them accountable to meeting customer needs and organizational goals. Facilitates the ongoing learning, well-being, professional satisfaction and development of staff through training, work assignments, increased responsibility and mentoring
Identifies opportunities for process improvement, and implements them by engaging stakeholders throughout the organization. Understands interrelationships among systems and process across functional areas to redesign process, improve efficiency, and ensure optimal results. Applies thorough understanding of key business processes to effectively anticipate and address the longer term implications of decisions/actions. Provides oversight regarding the development of business cases, in conjunction with other relevant SME's, that facilitate local or regional revenue cycle strategies. Coordinates and implements revenue cycle initiatives, including identifying and assembling resources when necessary. Formulates and makes recommendations to leadership on policies and practices relating to revenue cycle improvements
Master's degree preferred

Managing Director, Revenue Cycle Solutions Resume Examples & Samples

Bachelor’s Degree (MBA or advanced degree highly appreciated, but those with a bachelor’s and strong experience will be considered)
Health care industry experience
Experience managing client relationships
Demonstrated strong communication skills
Experience working with clients in a consultative role -- comfort engaging senior level people in back-and-forth conversation, ability to be convincing when necessary, and ability to develop strong relationships through each interaction
Proven ability to communicate effectively with senior executives
Practical experience either consulting to or working in hospitals
A high level understanding of the transition to value, whether from project experience in a past firm or operational experience in the field
Experience in developing growth strategies for organization(s), particularly around new business lines
Experience working in a team environment, as well as independently and autonomously
Experience managing and coaching more junior team members
Experience conducting root-cause analysis
Demonstrated experience meeting deadlines
Willingness to take risks and act decisively with regard to new opportunities

Director Revenue Cycle Resume Examples & Samples

Participates in revenue cycle/billing, denial management/follow-up, Patient Access Services, HIM, lab and other hospital-based work teams
Maintains current policies and procedures for all departmental functions
Performs XClaim and Revenue Recover training in Revenue Cycle Systems for new users and monitors departmental clean-up of work lists
Monitors high dollar and aging accounts (unbilled, denials, follow-up) in systems for escalation with departments (DNFB, XClaim, Revenue Recover, RTS)
Assist departments with resolving batch rejections daily
Attends weekly CBO meeting to review revenue cycle activities and address open-items with departments (billing, AR/follow-up, cash posting, CDM and vendor management)
Attends monthly Patient Access Management meetings to provide feedback and address open items with local management regarding Revenue Cycle related activities being completed within the facilities
Appropriately manages the Patient Access associates in all areas of employee selection, training, evaluation, coaching and counseling,
Maintains knowledge of all Patient Access areas ensuring a high productivity and proficiency standards of performance are achieved at all times
Work collaboratively with all internal and external customers and departments to ensure timely and accurate patient registration and processing related to all aspects of the patient and revenue cycle process
Ensures all associates are trained in the policies, procedures and processes of Patient Access to achieve consistent and quality outcomes
Protects the financial stability of the patient and hospital by ensuring all point of service collections are accurately and appropriately communicated and obtained prior to service or acceptable financial arrangements are made
Ensure that all compliance and audit requirements are understood, consistently followed and current in tracking and monitoring requirements
Makes suggestions for process improvements and develops plans for process improvement with successful implementation
Understands and stay abreast of payer requirements and changes within the industry. Able to share this information with staff for improved overall job understanding
Able to motivate staff to achieve stated departmental goals, improving service and outcomes
Is responsible for ongoing development of his/her work skills through the use of available resources (i.e.: in-services, formal education programs, other work groups and on-the-job training)
Attends and participates in staff meetings and in-services and/or reviews documentation as required
Assists in the orientation of others and actively participates in mentoring
Performs analytical and decision making functions with minimal supervision
Recognizes and seeks assistance/consultation when appropriate
Possesses awareness of programs/services provided by hospital and where they are located
Ensures compliance with relevant regulations, standards and directives from regulatory agencies and third party payors
In-depth knowledge of healthcare collection and billing practices and computer systems
Working knowledge of Microsoft PC applications (Outlook, Word, Excel, Access)
Ability to foster a cooperative work environment
Analytical skills necessary to examine patient accounts; detect and resolve problems relating to accounts receivable and prepare and administer policies, procedures and budgets

Director, Revenue Cycle Services Resume Examples & Samples

Manage communication and processes between business units to identify areas of improvement, align best practice methods and maximize revenue within federal and corporate compliance requirements
Identifying, analyzing and resolving all revenue cycle issues associated with billing, self-pay and insurance collections, A/R resolution, patient access/scheduling, and revenue enhancement
Establish and track key metrics such as A/R Aging, Cash Collections, Op Budget v Actual, Productivity, QA
Establish productivity monitoring for staff to maximize resources and results
Set processes and tools in place to consistently achieve monthly cash goals
Provide regular reporting and communication back to client
Provide assistance/resolution to external and internal client inquiries around patient financial service activities
Act as a technical expert in regards to financial class resoonsibility, to answer questisn raised by clients and team members
Maintain a current working knowledge of all patient tfinancial and healthcare related issues and regulations
Responsible for identifying and reporting any detected trends in payments denials, procedural issues and makes recommendations internally
Analyze and solve problems quickly and thoroughly
Responsible for reporting violations of the company's policies and procedures, Standards of Business Conduct, governance program, laws and regulations through the company's Help Line or other mechanism that may be available at the time of the violation. Assists with internal control failure remediation efforts
Becomes knowledgeable of internal control responsibilities through training and instruction. Responsible and accountable for internal control performance within their area of responsibility. Participates in the internal controls self-assessment process
Minimum of 7 years of patient accounts management experience in a Manager or Director capacity with hands-on experience and oversight of billing, collection, customer service and cash application. Has the ability to represent the revenue cycle within the organization
Capable of critical thinking and exhibits advanced analytical skills
Manages financial resources effectively
Excellent people management skills
Solid knowledge of all MS Office Products as well as Collections Workflow tools

Clinical Director, Revenue Cycle Resume Examples & Samples

Hold and maintain an unrestricted medical license in the state of BSHSI local system
Previous managed care medical director experience
Meet the requirements (and become a member) of the Local System Hospital medical staff
Possess or acquires a solid foundation, knowledge, and/or experience in the areas of utilization management, quality improvement, and patient safety
Possess a working knowledge of (Hospital) organization & case management operations and administrative standards and policies
Strong computer skills and working knowledge of the EMR
Familiarity with MCG/Interqual placement status criteria is preferred
Ability to build rapport with medical staff and hospital leadership to obtain the buy-in and collaboration necessary to achieve desired outcomes

Senior Director, Revenue Cycle Operations Resume Examples & Samples

At least 5 years of experience in a leadership role in the area of patient accounting for a large, multi-specialty medical group
Servant leader perspective with a proven record to attain excellence in operational standards within a large, complex healthcare organization
Previous experience in client relationship management. One must possess the demonstrated ability and commitment to quality and customer service to both internal and external clients
Demonstrated proficiency in situational and change leadership, effective fiscal management, resource allocation, strategy and planning within a dynamic environment
Master’s Degree in Business, Healthcare, or other related discipline
Experience with and knowledge of Epic for both hospital and physician/ambulatory operations

System Director Revenue Cycle Resume Examples & Samples

Creates exceptional customer experiences by ensuring that patient care and experience is the focus for assigned functions. This includes understanding changing customer expectations and seeking innovative ways to create excellent service
Understands the business of Healthcare by keeping updated and understanding applicable federal/state laws and regulatory agency standards. In addition, keeps updated and understands current trends in Healthcare and Healthcare Revenue Cycle and incorporates these trends, as appropriate, into assigned functions
Thinks strategically by translating strategy into actionable plans. Thoroughly understands the strengths and weakness of the staff, department, organization and competitors. Recognizes business opportunities
Pursues innovation by fostering a culture of experimentation and tolerance for mistakes. Encourages curiosity and creative dissatisfaction with the status quo
Strives for results by pushing decision making as far down in the function as possible. Tracks and studies decision results in order to continually improve. Has leadership team fully committed to listening to and engaging employees
Communicates skillfully using different styles appropriate to the audience. Consistently probes for the underlying concerns of others and finds ways to connect to and address those concerns
Lead an environment where team members are fully engaged in their work, have an understanding of what the organization is set to accomplish and strive to be the best in their field

Senior Director, Revenue Cycle Operations Resume Examples & Samples

Provides leadership to ensure timely, efficient, and accurate processing of claims; timely initial billing, follow-up, payment posting, denial management, self-pay A/R and bad debt program management
Develops mechanisms to assess and measure service levels and client satisfaction
Defining and implementing programs and initiatives to support the SPS Business Plan
Extensive knowledge and experience in revenue cycle operations and large scale receivables management
Knowledge and experience in HMO contracting and payment mechanisms
Knowledge of specialized software and systems related to departmental operations, including Epic, ChangeHealthcare, On-Base, etc
Demonstrated successful managerial experience in managing large business office production shops in a service center environment
Ability to communicate effectively both orally and in writing; and present information and respond to questions from groups of clients, customers, managers, and the public
Human Resources Management skills to hire and train employees, appraise work performance, address employee relations issues, and resolve problems
Epic Resolute

Director, Revenue Cycle Management Resume Examples & Samples

Consistently exhibits behavior and communication skills that demonstrate HealthCare Partners’ (HCP) commitment to superior customer service, including quality, care and concern with each and every internal and external customer
Uses, protects, and discloses HCP patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
· Ensures correct and timely delivery of reports and metrics to AVP and Leadership
Manages and directs the Billing and Coding mangers and Billing Office team and Billing Office operations
Responsible for quality, regulatory and continuous improvement within the job scope
Responsible for all actions/responsibilities as described in company controlled documentation for this position, as well as, delegated by AVP
Contributes to and supports the corporation’s quality initiatives by planning, communicating, and encouraging team and individual contributions toward the corporation’s quality improvement efforts
Directs the Billing team and operations including Distribution, Data Entry, Eligibility, Coding, Accounts Receivable, Collections, Patient Account Services, payment posting, System Support, etc.
Develops policies and procedures for the business office operations and ensure operations are efficient, effective, meet all regulatory guidelines and consistently being utilized
Ensures all teammates are knowledgeable on Billing Department’s SOX Narrative and follow all processes. Ensures adherence to SOX Narrative
Works with providers, Operational Directors, etc. on issues regarding to the Billing department
Collaborates with outside vendors on resolving system questions and problems
Responsible for collections on account receivables and maximize cash collections through a variety of processes, and ongoing operational evaluation
Evaluates the training needs of the Billing Office team and plans, develops and conducts training programs as needed
Recommend quality and/or process improvement initiatives in order to improve the efficiencies of the Billing Operation
Interviews, hires, trains and delegates work to team members. Prepare timely performance evaluations and take disciplinary action or discharge personnel when necessary
Direct year-end audit process, including preparation and/or review of all required audit schedules
Develop and directs contingency plans designed to correct bottlenecks and backlogs to reach productivity, efficiency, collection and customer service goals
Performs additional duties as assigned
Education
10+ years of physician revenue cycle and supervisory experience
Extensive knowledge of the healthcare professional revenue cycle environment, application of strategic AR workflow and a strong understanding of medical billing principles
Extensive knowledge of AR billing systems and utility management as it relates to production and system reporting
Ability to actively participate in budget development and carry responsibility for achievement of budget targets
Working knowledge of Microsoft Word, Excel (including pivot tables), PowerPoint and Outlook
Ability to perform and complete projects in a timely manner with minimal supervision in a fast paced environment
Ability to foster open communication, team build, and encourage and maintain team morale

Director, Revenue Cycle Management Resume Examples & Samples

Corroborate Optum360 Service Level Agreement performance and calculate performance credits
Develop and monitor all financial and performance reports
Develop Dignity/Optum360 communication structure
Bridge plan development and monitor Optum360 achievement
Develop policies for all Dignity retained revenue services responsibilities
Manages, coordinates, and champions multiple revenue cycle initiatives across the organization to improve processes and support optimal revenue cycle performance
Oversees the revenue charge capture system to promote its accuracy and integrity across revenue- generating departments of the organization
Collaborates with Optum360 and Managed Care to ensure the Expected Reimbursement system is maintained and providing accurate results
Consults with facility directors to help develop and implement policies and procedures for the purposes of reconciling charges posted in the billing system with other source information
Facilitates understanding, compliance, and completeness of clinical documentation while maintaining the ability to collect, analyze, and interpret data (CDI) for physician endorsement of program initiatives
Identifies opportunities for charge capture improvement by implementing and analyzing the results of routine, random audits
Develops tools for the purposes of tracking and identifying potential areas of lost revenue
Educates staff regarding the appropriate application of CCI, medical necessity, etc. edits
Stays apprised of ICD-10 coding standards/updates while providing ICD-10 education and training to coding staff
Helps maintain and enhance the chargemaster; reviews organizational charge structures to assure that charges accurately reflect services and supplies provided and are consistent with current industry best practices
Reviews changes in pricing, CPT codes, HCPCS codes, and revenue codes for accuracy and compliance with all applicable billing guidelines and optimization of reimbursement
Provides oversight for organization’s clinical documentation improvement program in a standardized manner and oversees the integrity of financial and clinical interfaces, while facilitating the development of strategic system planning
Collaborates in the development of programs, initiatives, and workflows, which provide alignment with education for internal customers to support clinical documentation guidelines
Conducts quality assurance reviews on CDI processes and functions, resulting in the reporting of any corrective action
Serves as an expert resource in reviewing medical records in support of consistent documentation for all payer types (i.e., Medicare Advantage, RACs, etc.) to ensure complete and accurate diagnosis capture and coding
Ensures staff members are knowledgeable about documentation needs and coding and reimbursement issues identified through documentation reviews and aggregate data analysis
Maintains knowledge of and adherence to code of conduct standards, confidentiality agreements, and the organization-wide mission statement
Serves as primary point person for CHAN and works in collaboration with CHAN and Optum360 to resolve open audit findings
At least five years of progressive experience in managing healthcare business functions
At least three years of clinical healthcare experience (i.e. clinical documentation, and/or case management reviews)
Exceptional verbal, interpersonal, and written communication skills
Ability to influence key stakeholders at various organizational levels
Strong leadership skills and commitment to a team approach; both direct and indirect reports
Competency in developing efficient and effective solutions to complex business challenges
Strong accounting foundation required and familiarity Revenue Cycle relationship with a financial statements
Familiarity with management reporting, metrics and goal setting
Excellent knowledge of revenue cycle and other healthcare financial performance metrics
Deep familiarity with revenue cycle policies and procedures
Extensive knowledge of current healthcare trends, policies, and regulations
Understanding of coding classifications systems such as, but not limited to, ICD-10-CM, ICD-9-CM, MS~DRG, APR~DRGs, and HCCs strongly preferred
Comprehensive understanding of computer, database, and network technologies

Director, Revenue Cycle Resume Examples & Samples

Manages at least two complex Revenue Cycle engagements concurrently and keeps teams and clients on track
Builds strong relationships and manages existing clients while growing the revenue cycle portfolio
Serves as one of the practice leaders developing the RCM staff with the lens of increased responsibility and promotion
Produces quality of methodology and engagement deliverables
Providing strategic analysis/assessments for our clients resulting in long term RCM transformational work
Working collaboratively within a team setting
Leverages his/her strong data analysis abilities towards positive client outcomes
Mentors, develops and coaches new and existing staff
Previous experience in selling revenue cycle and operation improvement solutions and Consulting Services to the larger Health Provider profit, not for profit and academic clients. Minimum of 4yrs + experience in this capacity
At least 10 to 15 years of sales and/or delivery experience at the executive levels of the health provider clients selling and delivering revenue cycle (back office, patient access, denials reduction, cost reduction, revenue cycle IT optimization and shared services) solutions into the healthcare industry with a proven track record of executive sales success
Action-oriented, results -oriented, "take charge" attitude, capable of developing a strong business case for client action and the skills to bring those to close
Minimum 4+ years of first tier consulting experience developing and delivering revenue cycle and operational solutions into the healthcare provide with a proven track record of delivered success
Experience working with EMRs across the revenue cycle discipline (preferably with Epic or Cerner)
Strong executive presence and professional image. High comfort level interacting with the highest levels of client leadership
A team player; a highly collaborative, team oriented process. Leads development of opportunities and management of team resources to grow the business
Undergraduate degree required
Entrepreneurial background and/or capabilities highly preferred

Regional Director, Revenue Cycle Resume Examples & Samples

1)____________________________________________________________________________________________
Ensures achievement of business objectives, including meeting company Days Sales Outstanding (DSO) and Accounts Receivable (AR) key performance metric standards
Implements and monitors adherence to company Reimbursement policies and procedures. Effective use of practice resources to drive optimal revenue cycle outcomes for the practices
2)__________________________________________________________________________________
3)___________________________________________________________________________________
Participates in monthly practice operation meetings and Joint Policy Boards to provide data and feedback to physicians on business related functions and overall AR management. Prepares regular and ad-hoc reports for board and practice management use
4)___________________________________________________________________________________
5)___________________________________________________________________________________
At least twelve (12) years of Revenue Cycle Management to include knowledge of revenue cycle operations processes with the ability to identify opportunities to improve revenue cycle management
At least (5) years supervisory experience coaching, developing, and managing staff
Previous experience managing a RBO, CBO or Medical Billing Office (Oncology medical & radiation, diagnostic imaging, and lab billing, preferred)
Influencing skills to gain acceptance of best practices from senior leaders, board members, and physician at practices
Billing system platform experience (esp. Centricity Business strongly preferred)
Ability to effectively communicate and interact with Physicians and staff (preferably in a community practice setting)
Strong analytical and reporting skills, preferred

Director, Revenue Cycle Resume Examples & Samples

Responsible for the successful operation and performance of the centralized-business office, revenue cycle professional services for Steward Health Care System
Oversees the day-to-day operations of professional billing, denials, appeals/follow-up
Works collaboratively with other departments/senior leadership to identify, install & manage revenue performance improvement initiatives
Measure & manage staff performance/productivity and employment standards
Promote continuous process improvements and participate in shared services initiatives
Understanding & educate on payer rules, regulations and guidelines to ensure ethical and compliant standards
Provide analysis and data driven recommendations to senior management
Demonstrate excellent communication skills, both written and verbal
Demonstrate ability to set priorities and manage multiple projects simultaneously
Demonstrates respect and regard for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment
Full knowledge of the Microsoft Suite applications
Performs other duties as assigned knowledge and skills
5+ years management experience in revenue operations in an Athena environment
Proven knowledge of professional operations including best practices regarding workflow, quality monitoring, coaching and training - to lead a team to maximize cash performance & DSO management
Bachelor's Degree Preferred or equivalent experience, MBA a plus
Process expertise in a multi-hospital/physician system and central business office
Certification/Licensure: AAPC, HFMA, certifications a plus
Software/Hardware: Applicable billing and claims software

Project Director, Revenue Cycle Resume Examples & Samples

Serve as the bridge between ARCR Team, Clinical Informatics Team and the eRecord implementation staff
Conducts feasibility studies, prepares analyses and presents recommendations
Helps Epic staff understand our operational needs as we validate workflows and model system configuration
Ensures coordination of all issues that arise for their application area and complete decision documents where appropriate
Benchmark with other like insitutions to ensure best pratices are followed, lessons learned are avoided and risks can be anticipated and managed
Work with Epic representatives, other departments, ARCR Teamand URMC’s Clinical Informaticists to ensure the system meets needs

Director Revenue Cycle Operations Resume Examples & Samples

Implement strategic initiatives; communicate plans and goals; engage team to drive goals and objectives forward
Establish key performance indicators and metrics
Ensure claims meet payor’s definition of acceptable claim in form and content
Ensure claims accurately reflect services provided by DaVitaRx and expected revenue
Ensure review, revision, development, and implementation of department policies, procedures, and compliance with all regulatory agencies
Ensure adequate training of department teammates in all areas including compliance with DaVita policies and procedures, and Federal/State billing regulations and guidelines
Minimum of seven (7) years’ experience in managing complex operational and support functions required; experience in Healthcare, Consulting, or Insurance industries preferred
Minimum of seven (7) years’ supervisory experience required
Demonstrated in-depth knowledge and understanding of Healthcare Revenue Operations and the roles of teammates to accomplish goals preferred
Demonstrated strengths in analytical and financial skills
Advanced computer skills and proficiency in MS Excel required; intermediate computer skills and proficiency in MS Word, Outlook, and PowerPoint required
Demonstrated ability to communicate difficult or sensitive information tactfully
Proven leadership skills and the ability to collaborate across functions and with all levels of the organization
Demonstrated consultative skills when addressing complex inquiries
Demonstrated presentation and persuasion skills
Proven visionary with ability to plan and execute projects that impact mission, goals, and objectives
Demonstrated ability to analyze the short- and long-term needs of the organization

Director Revenue Cycle Finance Resume Examples & Samples

General accounting and financial management roles with 8 - 15 years’ work experience; including 5 years minimum in managerial capacity
Ten years (10) in financial analysis with experience in budgeting, forecasting, strategic and capital planning, analysis and project management
Requires a high level of effective written and verbal communication skills to present financial results to various audiences
Requires high analytical level to interpret and communicate financial, operative, performance and strategic information
Financial presentation skills at Committee or Board level
Strong knowledge of GAAP, financial analysis, and computer skills, including advanced Excel and PowerPoint skills
Understand operation and process improvement methods, change management, Lean Six Sigma or project management certifications a plus
A Master's degree in Business Administration, Healthcare Administration, Public Administration, or a related field
CMA and/or CPA certification is a plus

Director, Revenue Cycle Mangement Resume Examples & Samples

Deep revenue cycle operational and business knowledge
In-depth knowledge and understanding of healthcare billing services (professional or technical), regulatory requirements, clinical data management and project management
Experience managing registration or revenue/billing functions within a healthcare setting and leading cross-functional teams
Understanding of hospital cash ¬ flow management, performance reporting and enterprise analytics
Experience developing and executing project plans in a matrixed and complex environment
This role is a key component of the URMC eRecord (Epic) Enterprise Application Suite
Serves as the advisor to institutional leadership on policy, procedures, and practice changes as it relates to information systems, attends senior leadership forums
Ensures an integrated, operational approach to information system implementation, operation, and realization of benefits through business process and technology changes
Engages a broad, diverse group of stakeholders, and builds consensus on the technical, functional and workflow design required for the implementation
Proactively identifies project risks and develops a risk management plan for mitigating those risks.Strictly manages the project scope
Directs and supervises staff and resources to assure efficient and effective operations.Ensures an integrated, operational engagement approach to all implementation and operations activities

Assistant Director, Revenue Cycle Operations Resume Examples & Samples

Directs teams responsible for provider enrollment, cash posting, credit resolution and mail/correspondence processing to ensure payments are posted in a timely manner and credits are resolved in compliance with governmental regulations
Ensures payments received are accurate according to negotiated payor agreements, securing additional payments when negotiated rates have not been adhered to
Bachelor’s degree with emphasis in finance, accounting, business management or healthcare administration
Five plus (5+) years of experience in a manager-level role with oversight of billing, collections or payment operations in a large, group practice
Prior experience with revenue cycle practice management systems interfacing with multiple clinical systems
Metrics driven with strong analytical and project management skills
Extensive knowledge of revenue cycle metrics and drivers, particularly in billing and collections (AR days, cash goals, aging, and compliance metrics) and the technology tools utilized to deliver and improve performance (claims clearinghouses, advanced AR management workflow tools, disputed claims management)
MBA or Masters' Degree
Three plus (3+) years of experience in a senior level position with oversight of billing and collection operations in a large multi-specialty group practice in an Academic setting
Five plus (5+) years of progressive management responsibility for an organization in similar scope (500+ providers, revenues >$175M and 50+ FTEs). *Six Sigma or other Lean Management Training. *Epic Certified

Assistant Director, Revenue Cycle Resume Examples & Samples

A Bachelors' Degree with emphasis in finance, accounting, business management or healthcare administration
Five plus (5+) years' experience in a senior-level role, or eight plus (8+) years experience in a manager-level role with oversight of billing and collections operations in a large, multi-specialty group practice of 200+ providers with revenues >$100M
ICD10, Medical Group financial management experience
Strong interpersonal skills with the ability to present information in a clear and concise manner
Six Sigma or other Lean Management Training
Epic Certified
Seven plus (7+) years' experience in a director level position with oversight of billing and collection operations in a large multi-specialty group practice in an Academic setting
Five plus (5+) years' of progressing management responsibility for an organization in similar scope (500+ providers, revenues >$175M and 50+ FTEs)

Corporate Director, Revenue Cycle Resume Examples & Samples

Technical Expertise – Understanding of healthcare including knowledge of healthcare terms and accounts receivable processes
Strategic Analysis - Analytical review skills and ability to make decisions based on analysis
Financial management - applies tools and processes to successfully manage to budget
Communication - communicates clearly and concisely, verbally and in writing. This includes utilizing proper punctuation, correct spelling and the ability to transcribe accurately. The ability to communicate with staff, Parallon management, division and group executives. Instills confidence when communicating
Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
Basic skills - demonstrates ability to organize, perform and track multiple tasks accurately in short timeframes, have ability to work quickly and accurately in a fast-paced environment while managing multiple demands, ability to work both independently and collaboratively as a team player, adaptability, analytical and problem solving ability, attention to detail, and able to perform basic mathematical calculations, balance and reconcile figures, has a sense of urgency
Minimum five years healthcare management experience with three of these years in the related area for the position
Relevant education may substitute experience requirement with SSC Executive approval

Director, Revenue Cycle Management Resume Examples & Samples

Direct day-to-day operations, priorities and broad scope work assignments with the focus on maximizing quality and production processes
Develop and monitor reporting tools to track Key Performance Indicators (KPIs), (e.g., A/R, DSO, Cash Collections, and Aging Reports by Payor). Make recommendations and implement continual process improvements to improve performance. Communicate information as appropriate
Monitor and manage overall collections strategies. (e.g., enforcement of standard operating procedures, monitoring of production and quality, reviewing RCM Key Performance Indicators)
Develop in-depth intimacy with RCM functions and operations, including the flow of trip ticket inventory, cash receipts and write-off patterns. (By day/week of month, typical problems and issues)
Set goals jointly with subordinates; clearly communicates goals and objectives; monitors results and meets with subordinates regularly to discuss outcomes. Provides coaching and counseling as needed and ensures performance concerns are documented
Respond to AMR Operations and EVHC finance team with appropriate analysis and executive-level communications, highlighting: performance, costs, and effectiveness of the billing and collections function
Work closely with AMR’s Arizona VPO, Regional Directors (RD) and other members of Operations, as well as other departments within AMR, to convey issues and propose solutions that will improve efficiencies, and/or reduce costs
Delegate appropriately to subordinates; communicate clearly and thoroughly expectations regarding all delegated work
Forecast and anticipate other operating expense needs (e.g., travel, training, and consulting). Make recommendations to VP regarding operating and capital budgets
Continually monitor the regulatory environments to ensure that payors evolving reimbursement structures, documentation requirements, and other requirements are evaluated and necessary changes in policies and procedures (and systems) are made
Establish and maintain open communications with contract facility customers. Monitor key performance indicators and collections goals, resolve billing issues and ensure timely payments
Insure training and quality standards, as well as resources, are in place for designated departments. Insure the integration of new hires into the PBS operation and provide “refresher” training for existing employees
Provide “technical” direction to the team. Review and recommend for approval new Standard Operating Procedures (SOPs), training manuals, and other documents, (e.g., job descriptions)
Maintain a stable work force, minimize turnover and optimize the selection of high caliber recruits
Avert and resolve conflicts among subordinates; set priorities and assign work in a fair and consistent manner to avoid conflicts and misunderstandings among team members
Ensure that new trainees and staff have adequate opportunities for full, complete training. Ensure that sufficient monitoring of staff work occurs and that “refresher” training is available to those who require it
Respond to changing business environment. Modify work processes, SOPs and job descriptions as necessary
Adhere to and comply with information systems security. Know and follow Information Systems security policies and procedures. Attend Information Systems security training, when offered. Report information systems security problems
Mentor employees, conduct performance evaluations, counsel and provide corrective actions to assigned personnel, and work to facilitate individual and team development that drives positive results. Champion affirmative action efforts in all aspects of employment, including but not limited to staffing, training, and promotions. Responsible for compliance with and enforcement of company/department policies and procedures
Develop and sustain excellent working relationships with AMR professionals (e.g., Operations, Business Development, IT and Finance), as well as with the Company’s clients, payors, consultants, banks and financial intermediaries and government agencies
Present image to subordinates, superiors, and client-users (Operations RCEOs and RDs) as: knowledgeable, creative, energetic, and assertive
Convey an attitude of intolerance for unprofessional behavior
Promote an environment of mutual respect, courtesy and value of others’ opinions/ideas
Set example as friendly, helpful “firm but fair” management and leadership for subordinates
Work well with other leaders to communicate and share resources on critical projects. Seek opportunities to help others’ projects by sharing and reallocating team members’ priorities and assignments
Seek opportunities to improve work environment
Convey a sense of “can do”, “team spirit”, and “inspirational” behavior
Medical care/medical transportation (patient care issues, how patients are transported by ambulance, required documentation, common issues which arise during transport and/or billing)
Rules/regulations of Medicare/Medicaid and other government payors as well as commercial insurers and specialty contracts
Medical and insurance industry terminology
Condition codes, ICD-10 codes, CPT codes and HCPCS coding schemes
Hospital information systems, including data stored and prominent functions which occur in the following departments( Admissions, Medical Records, Order Entry, Discharge Planning, Patient Accounting)
EVHC/AMR business models
Assist in the evaluation of new tools to improve work flow and work methods
Maintain fluency with (working knowledge of) various tools

Senior Director Revenue Cycle Management Resume Examples & Samples

Organizes and directs all activities to ensure control and management of patient accounts receivable, which includes charge capture, claims production, claims scrubbing, billing, collections, customer service, denial management , cash posting, and follow-up on collection services
Implements and manages efficient and effective operational policies, processes, and best practices within the functions of the revenue cycle
Possesses extensive knowledge of revenue cycle and regulatory requirements associated with governmental, managed care and commercial payers
Serves as the subject-matter expert on regulatory, compliance, and legal requirements associated with medical billing and CMS. Ensures compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers
Leads the development and implementation of revenue strategizes to maximize profitability
Develops and maintains internal controls to target revenue recovery throughout the organization by identifying charge capture, coding, and reimbursement problems then recommending / implementing solutions
Assists in identification of new technologies that will improve departmental operations. Identify and communicate overall strategy for improvements to the revenue management cycle
Ensure all critical business needs and requirements are identified and met with automated/manual processes
Ensures the integration and alignment of revenue cycle management operational activities to drive standardization, and to streamline and increase operational efficiency
Acts as liaison with internal and external business partners and departments
Manage payer data to determine denial and underpayment trends to accomplish business objectives
Oversee resubmission of denials and ensures that department is maximizing reimbursement to efficiently lower A/R and speed up revenue cycle
Administer "data mining" and in-depth accounts receivable analysis
Works collaboratively with the VP of Revenue Cycle to support department initiatives
Ensure adequate internal controls are in place to recruit, develop and maintain a competent and productive team; responsible for staff development and related goal setting/performance standard with the Revenue Cycles managers and staff
Decision making in regards to recruits, selects and orients/manages staff
All other duties as assigned and/or appropriate to the work described herein or as it relates to being a senior leader in the organization
Creates a model that supports the organization's mission and values based on an internal and external needs assessment
Monitors the internal/external environment and identifies opportunities to fulfill the corporate strategy
Sets priorities for planning activities for assigned unit
Serves as strategic liaison for key organizational initiatives between business units and their customers, both internal and external
Assesses current models of business operations and develops appropriate new models as needed
Participates in policy development
At least 5 years professional experience in healthcare revenue cycle management with at least 3-5 years in a senior management role managing a staff of professionals in the revenue cycle environment
Ability to work on various assignments simultaneously
Knowledge of policies and practices involved in the human resources function
Ability to manage a staff in a positive and productive manner by motivating, developing and managing employees as they work
Ability to utilize and administer the disciplinary action process through coaching and counseling to improve performance or terminate employment
Ability to communicate tactfully, verbally and in writing with department heads, managers, coworkers and vendors to resolve problems and negotiate resolutions
Working knowledge of computers, internet access, and the ability to navigate within an automated systems as well as a variety of software packages such as Outlook, Excel and Word
Strong leadership and management skills in a healthcare setting
Extensive understanding of all revenue cycle functions and dependencies
Advanced knowledge of healthcare reimbursement methodologies
Proven capabilities in building an organization and directing teams. Ability to work with others in a cooperative, collaborative manner
Ability to prioritize and manage multiple tasks simultaneously, and to effectively anticipate and respond to issues as needed in a dynamic work environment
Excellent written communication, verbal communication, interpersonal, time management and organizational skills
Self-directed with the ability to work with various stakeholders and teams
Ability to make quality, independent decisions as well as the ability to collaborate effectively to make decisions with other leaders
Ability to work effectively and efficiently under tight deadlines and multiple interruptions

Director Revenue Cycle Resume Examples & Samples

We recognize and affirm the unique and intrinsic worth of each individual
We treat all those we serve with compassion and kindness
We act with absolute honesty, integrity and fairness in the way we conduct our business and the way we live our lives
We trust our colleagues as valuable members of our healthcare team and pledge to treat one another with loyalty, respect and dignity

Director, Revenue Cycle Mgmt Resume Examples & Samples

Manages administrative direction of assigned accounts receivable department(s)
Bachelor’s Degree in Finance or Accounting, required. Master’s Degree, preferred
Minimum of seven (7) years experience in healthcare finance administration including three (3) years supervisory experience

Director, Revenue Cycle Systems Resume Examples & Samples

Upholds the values and mission of the Tandem Hospital Partners family
Implemented Hospital and Professional Billing Revenue Cycle Systems
Subject Matter Expert in central billing office and build of revenue cycle applications utilized across the organization
Ensure the integrity of the Revenue Cycle Systems databases and Master File and Dictionary Configuration
Participate in audit and execute recommendations for improvement of revenue cycle systems
Lead large-scale hospital partner and THP projects and cross functional teams with medium to high complexity
Build, testing of applications and systems, and elbow to elbow in person and web based go live support
Participate in the formulation of annual budget and goal reviews for the information technology department
Perform RFP and analysis of new or replacement systems and technologies
Coordinates and achieve buy-in of front-end staff education, training, and communication for promoting denial prevention, accurate demographics and insurance verification, and point of service collections
Responsible for building consensus, change agent, and promote adoption of best practices and innovations among stakeholders
Design and build dashboards, analytics, and reports to track key performance indicators such as to manage accounts receivables, claim denials, zero payments, daily cash reports, etc
Experienced developing and presenting training programs to the central billing office
Recruit, manage, hire, mentor, knowledge sharing of team of revenue cycle systems managers, analysts, interns
Ensure HIPAA compliance, safeguards, privacy and security of protected health information
Understands company operational and clinical systems, answers technical questions and performs all assigned tasks
Use tools provided to develop and maintain applications, reports and other solutions
Maintains detailed technical knowledge of assigned systems
Work with hospital partner clinical teams on workflows, build, testing and training
Identifies issues and concerns and communicates them to the leadership team. Develops options and recommendations
Assists customers with optimizing their use of assigned systems and specific project-driven tasks. Participates in application support as needed
Performs other duties and special projects as assigned by the VP of IT or Chief Technology Officer
Adhere to all THP policies, procedures, and standards, within budgetary specifications, including time management, supply management, productivity, and accuracy of practice. Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor, and resource to less experienced staff
Bachelor’s degree or equivalent, required
Master’s Degree in Healthcare or Business Administration, preferred
Eight (8) years of increasingly responsible experience in a large, corporate systems development and implementation activities in a wide variety of Healthcare Management Information Systems (MIS)
Training experience in revenue cycle systems, workflows preferred
Licenses/Certifications: Licensed or credentialed with Epic Resolute HB and PB or Cerner Millennium or Soarian
Industry training and increasingly responsible experience with knowledge and skills in a large, complex corporate Information System
Basic working knowledge of application support, development tools and methodologies
Acute Care or Emergency Department Hospital and Professional Billing Background a plus
Hospital Management Leadership Experience Recommended
Experience or Certification in Epic Resolute HB and PB, Cerner Millennium or Soarian, GE Centricity PM, Zirmed Clearinghouse Recommended
Experience in Nuance or 3M Encoder, Cactus Credentialing, Adobe Captivate, Data Warehouse Reporting
Passion for innovation
Excellent written, oral and interpersonal communication skills
Excellent understanding of the organizations goals and objectives
Ability to communicate effectively with all levels of staff
Highly self-motivated and directed, with keen attention to detail
Proven analytical and creative problem-solving abilities
Able to prioritize simultaneous projects and execute tasks in a high-pressure, short timeline environment
Ability to work in a team-oriented, collaborative environment
Ability to work with all levels of staff to define business requirements and goals, and to identify and resolve issues
Ability to foster effective relationships and build consensus through the all levels of leadership in the organization
Knowledge and ability to work on large-scale complex projects that include multiple strategic goals and multiple tactical tasks
Knowledge and ability of needs, goals, deliverables and interdependencies of other functional departments
Able to keep a positive attitude and problem solving stance in difficult circumstances
Demonstrated proactive approaches to problem-solving with strong decision-making capability
Highly resourceful team-player, with the ability to be extremely effective independently

Director, Revenue Cycle Integration Resume Examples & Samples

Serve as the primary liaison between Corporate Revenue Cycle functions and Entity operations
Works with the Executive Director of Revenue Cycle Integration to set the standards for the interaction between the entity and the corporate Revenue Cycle Team
Build strong relationships and facilitate effective communication between hospital and physician-based Revenue Cycle and Clinical (where appropriate) operations, centralized Revenue Cycle operations (PAS, Middle Revenue Cycle Operations, PFS, Customer Service), and core support departments (e.g., human resources, business support services, compliance, finance)
Establishes and manages effective, consistent communication with assigned Entity; identifies and addresses business needs; conducts regular meetings with Entity CFO and Finance Director and key entity leadership. Provides analysis and context for monthly performance data. Document,
Monitor and facilitate service level agreements (SLAs) between hospital and physician-based Revenue Cycle operations (Patient Access, onsite HIM Operations) and other related functions, within both Revenue Cycle and Clinical operations as necessary
Develops and presents to Entity leadership on all aspects of the revenue cycle; trains entity resources on functions within the revenue cycle, as needed
Create a work environment for employees through team building, coaching, constructive feedback, work delegation, personal example and goal setting that encourages creativity, open dialogue on work issues, professional growth, and a consistent, high level of performance. Encourage and supports employee decision-making within their scope of responsibilities
Participates in and, where appropriate, leads cross-functional revenue cycle projects
Completes any duties and special assignments as requested

System Director Revenue Cycle Resume Examples & Samples

Review and design of processes that impact the revenue cycle across clinical and financial systems. Ensures that revenue integrity is established and preserved through all phases of system implementations, upgrades and maintenance. This includes creation, validation and reengineering of business/patient workflows that result in revenue generation and documentation required to support claim submission
Works closely with operational and technical teams and acts as a bridge to communicate functional needs, create tools and opportunities for improvement that support revenue cycle best practices in an integrated environment
Primarily focused on integration between the EHR, ADT, and HPA systems, but not limited to those systems – the Director ensures that workflows designed by various operational and technical teams are compatible and fully validated for efficient and safe results. Process designs leverage technology, promote first touch success for each user, and include controls to ensure timeliness and accuracy
Provides leadership to a variety of system projects and initiatives that impact the revenue cycle. This includes leading and participating on workgroups for Teletracking (centralized bed placement), ICD10, ADT/AR upgrades, EDI transaction development, and implementation of insurance eligibility and payer notification processes. Supports initiatives of clinical documentation improvement, front end speech implementation, medical necessity status determination and alignment between physician order/accommodation code/claim payment request, and accountable care organization development
Ensures the optimal and standardized use of front-end solutions for Patient Access Services to produce a zero-defect and fully compliant claim within 3days of discharge. Front-end solutions currently in use include hold bills/alerts, integrated electronic eligibility, financial status/application referral evaluation and reporting
Implementation and standardization of hospital ambulatory revenue management system application (ARMS) in conjunction with revenue cycle team, fully utilizing the advanced beneficiary notice, correct coding initiative/outpatient edits, and department communication tools. Implement ABN/NEMB process in all appropriate clinical settings
10 years of progressive revenue cycle management in an integrated healthcare environment with experience in all phases of hospital revenue cycle
10 years of technical experience working with ADT/AR, EHR, coding and ancillary systems
Expert ADT and HPA knowledge
Extensive knowledge of billing compliance and regulatory requirements for Title XXII, JCAHO, CMS, OSHPD
Extensive knowledge of regulatory requirements impacted by Access and Financial Service staff including, but not limited to Medicare Conditions of Participation, HIPAA, PHI, Fair Pricing, and EMTALA
Extensive knowledge of patient accounting systems, admitting and registration processes, and billing and collection processes
Understanding of processes and risks of combining/merging patient records and identities
Familiar with ICD10 and CAC (Computerized Assisted Coding)
Understanding of both Business and Clinical processes affecting Revenue Cycle and Patient Satisfaction
Case Management Background beneficial

Director, Revenue Cycle Management Resume Examples & Samples

Knowledge of Invision/SMS system, preferred
Healthcare Revenue Cycle experience strongly preferred
Prior radiation oncology experience a big plus!

Senior Director, Revenue Cycle Resume Examples & Samples

Coordinates with senior management on monitoring revenue cycle activities to ensure cost-effective revenue cycle processes. Lead cross functional teams in delivering high quality work products under set timelines
Interacts with medical and administrative staff to ensure compliance with policy and procedures, standards and regulations
Reviews and interprets operational problems/policies that ultimately generate denials and reduction in cash to practice managers. Resolves problems and recommends changes to senior leadership
Responsible for the ongoing oversight and monitoring of denials and cash variances by department. Recommends process improvements to reduce denials/issues
Works collaboratively with clinical departments regarding annual cash budgets
Contributes to capital selection process to ensure purchases support operations and growth
Collaborate with leadership on revenue cycle initiatives and operational processes with a financial impact. Evaluate the effectiveness and support of information technology applications to support operations
Supports and contributes to the key elements of operational practice, including, but not limited to, financial performance indicators and patients access to the system
Represents the department at public and professional meetings and conferences as requested. Facilitates communication and ensures proper flow of information
Coordinates, as requested, operational committees and physician advisory committees
Collects data, prepares reports, analyzes statistics, and responds to correspondence in a timely manner
Participates with the evaluation and negotiations of managed care contracts and operations in conjunction with senior management. Oversees payer relations in regards to communicating and resolving billing issues as they relate to the contracts
Handles special projects assigned by the Vice President of Revenue Cycle
Bachelors Degree or equivalent experience required. Advanced degree preferred (eg . MPH, MHA, MBA)
Minimum of five years in consulting, healthcare or physician practice required
Knowledge of healthcare revenue cycle management required
Practice management/medical billing computer programs. Epic and IDX experience preferred
Detailed Revenue Cycle management skills for report interpretation and application to common sense operations
Advanced critical thinking to see the larger picture through the details
Proficient experience in disarming conflict and delivering common resolution
Effective leadership experience in motivating teams and sharing vision
Strong professional interpersonal and proven teambuilding skills
Excellent verbal and written communication skills and experience with executive level business interaction
Demonstrated collaborative consulting approach to client and internal relationships
Proven ability to identify potential areas for additional services within current clients
Excellent organizational skills and detail orientation
Solid understanding of internal billing revenue cycle operations
Ability to thrive in a flexible work environment and to adapt to change
Ability to successfully work in self-directed environment
Must be able to work within the confines of internal teamwork while serving as a department advocate
Positive outlook towards issues and ability to develop and deliver resolution

Director, Revenue Cycle Resume Examples & Samples

Client Advisor – Rise to the level of trusted advisor to Clients, with respect to Client’s own performance, industry revenue cycle trends, and new revenue cycle technologies
Reporting and Analytics– Prepare and present to client performance reporting, as contracted and appropriate
Relationship Management -- Facilitate and maintain relationships through regular, pro-active communication, timely follow-through on requests and coordination of resources to meet client needs
Ongoing Client Leadership and Remediation (Issue Resolution). Identifies performance degradation and coordinate with Conifer Client Executive Leader, and the Conifer operational colleagues to ensure a mitigation plan has been implemented for the client
Manage the P&L to ensure proper controls are in place to maximize revenue opportunities and mitigate expenses
Develop and implement action plans to address and improve deficiencies in process and performance as identified
Reports on performance to client leadership, and regularly quantifies the benefit/accomplishments Conifer has delivered
Collaborates with on-site resources in service delivery and problem solving to maximize solution offering and client satisfaction
Assist with providing comprehensive, succinct updates to Conifer Leadership in order to drive awareness of any Client support requirements and/or risks that could impact service delivery
Position coordinates with Client Executive Leader
Central point of contact between Conifer service lines and the client regarding performance
Possesses the ability to build trusting relationships with Client Executives at all levels

Senior Director Revenue Cycle Resume Examples & Samples

Works with senior leadership to develop long term strategic roadmap to consolidate revenue cycle system portfolio
Develops and executes workplans to complete design; implementation of revenue cycle systems and transformed workflows for remaining medical group practices and hospitals
Facilitates complex integrated design session to drive often divergent senior leaders to a single decision to serve as the foundation for the build of future state applications and workflows
Establishes ongoing performance improvement infrastructure, including governance bodies, workgroups, and processes to facilitate a culture and expectation regarding ever-improving outcomes and efficiencies
Establishes administrative training program to consolidate existing revenue cycle training resources across the medical group and hospital organizations and develop, manage and maintain a curriculum to addresses application, workflow, and customer service skills required by administrative staff. Design training program to effectively balance classroom, web-based and practical application forums to manage the diverse educational needs of adult learner demographic
Collaborates with revenue cycle leadership to routinely monitor strategic operating goals and objectives and confirm ongoing transformation alignment with goals. Participates in operational performance, justification and/or corrective action efforts as appropriate
Collaborates with revenue cycle and practice senior leadership to evolve access to critical data to support ongoing business analytics and intelligence
Develops and oversees financial management including budget, salary, capital and revenue projections
Reviews, authorizes and prioritizes all financial and capital expenditures by assessing profitability, alignment with business objectives and budget parameters
Establishes and measures organizational performance against goals and objectives
Manages administrative direction of assigned department(s)
Assesses and makes recommendations to improve the efficiency of current systems/ processes
Formulates and implements policies and procedures to facilitate the efficient functioning of related departments
Develops and maintains current departmental manuals, where applicable
Develops financial programs consistent with changing regulatory and fiscal environment in accordance with Health System’s mission and vision
Promotes optimal efficiency and productivity by integrating functions across service lines
Selects, develops, manages and evaluates direct reports; and oversees the selection, development, management and evaluation of indirect reports
ADA Essential Functions
Bachelor’s Degree in Information Technology, Finance, Business Administration or related field, required. Master’s Degree, preferred
Minimum of ten (10) years progressively responsible management experience in related field to include two (2) years of advanced project management experience with major enterprise-wide initiatives, including technical implementations and workflow transformation and two (2) years of change management experience, required
Knowledge and experience developing fully integrated plans and schedules supporting large scale enterprise initiatives
Leadership, communication, presentation, relationship building and strategic planning and implementation skills, required
Knowledge of Invision/SMS, IDX, GECB, Soarian Financials, and Soarian Scheduling systems, preferred

Executive Director Revenue Cycle Management Resume Examples & Samples

Oversees all aspects of enterprise wide ICD 10 and EPIC Administration system implementation, by providing strategy, decision support, organizational planning and operational leadership to provide world class patient experiences
Oversees all aspects of enterprise wide RCM innovations and operational enhancements/ standardization by leveraging best practices and technology and providing strategic direction to create cohesive, compliant, streamlined and efficient environment that provides a world class patient experience
Provides leadership for developing and overseeing the processes and systems to improve admission, financial performance and generate cash flow
Leads multiple budgets and departments
Leads performance and results of divisions or departments which are enterprise wide in scope
Stays abreast of changing federal and state regulations and ensures system compliance
Works with stakeholders to understand complex issues, recognize decision points, and design and deliver creative solutions while partnering with a wide variety of constituencies including physicians a business partners
Communicates with executives across the organization
A minimum of 15 years of professional and functionally relevant experience, including 7 years of demonstrated management experience
A Master's degree may offset 5 years of required experience