Job: Director of Revenue Cycle

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Jobing Description


Director of Revenue Cycle

Location:Southeastern Regional Medical Center
Region:Atlanta, GA
Department:405001 Finance-Mgmt
Shift Hours / Days:
Hours / Pay Period:
Position ID:34277
Job Function:Management and Leadership

Description

CANCER TREATMENT CENTERS OF AMERICA (CTCA)

Cancer Treatment Centers of America (CTCA) is a national network of regional, destination hospitals specializing in complex and advanced-stage cancer care. The CTCA model integrates state-of-the-art treatments and technologies with nutrition, naturopathic medicine, mind-body medicine, oncology rehabilitation and spiritual support. CTCA employs over 3,000 talented Stakeholders (employees) who create, deliver and continually improve the Mother Standard of Care® based upon what cancer patients need and value. CTCA Stakeholders form the backbone of the CTCA experience; and their energy, and passion, creates a home of hope and healing to cancer patients across America.

CTCA's newest hospital is located in Newnan, Georgia which is located in the Metro Atlanta region. It is a 226,000-square-foot, all digital facility focused exclusively on treating cancer. It includes 50 beds, ICU rooms, surgical suites, state-of-the-art radiation and infusion therapy departments, outpatient clinic rehabilitation and physical therapy department and onsite residential accommodations for outpatients and their families. We are currently seeking dedicated Stakeholders to help us fulfill our Mission and provide the Mother Standard of Care® to patients in the Southeast.

OVERVIEW

The Director of Revenue Cycle Management is responsible for the leadership of hospital-wide initiatives and processes that are designed to support the capture, management, and collection of patient service revenue within the hospital. This begins with the ongoing maintenance and creation of the Charge Description Masters (CDMs). The Director will ultimately ensure smooth work flows, proper documentation, and compliance with both coding regulations and pricing policies as they all pertain to the Chargemaster. Building on the Chargemaster as the foundation for the revenue cycle, the Director will also be responsible for understanding and overseeing the various CDM interfaces across the clinical and billing systems from a finance perspective. This means the Director will work with IT and clinical leadership to ensure there is appropriate revenue capture and continuity upstream from the Chargemaster. Then, going beyond the CDM and its interfaces, the Director will establish processes and lead initiatives designed to address third-party payor reimbursement resulting from coding and documentation errors.

Serves as a leader within the Finance team participating in additional Finance projects including, but not limited to, the creation and review of pricing methodologies, price optimization, revenue generation, new service innovation and implementation, and other related tactical and strategic initiatives.

JOB RESPONSIBILITIES

Manage Talent

  • Guide, motivate and develop staff by providing timely and appropriate feedback throughout the year. Ensure annual goals are finalized and review is provided on time and with appropriate input.
  • Effectively communicate the mission of the organization/department to staff such that mission guides day-to-day activities.
  • Effectively prioritize staff and departmental work such that short and long-term benefits are balanced in day-to-day decision-making and problem solving.
  • Effectively plan resources in order to achieve CTCA goals regarding turnaround time and overall patient satisfaction.
  • Work with all direct reports on career development plans, and has a clear succession plan in place.

Ensure 100% charge entry and capture for each revenue generating department:

  • Provide leadership to the team of daily charge capture, charge entry and charge reconciliation to ensure the site is capturing 100% of the daily revenue generated by patients.
  • Maintain, and where necessary, improve upon the current CDM change processes within CodeCorrect so that the proper controls and documentation exist.
  • Ensure proper training and education for CTCA revenue department managers and their designees as it pertains to Chargemaster maintenance and related workflow management, charge process and reimbursement.
  • Develop audit plans to check revenue departments' billing practices against the CDM configuration and associated information systems.
  • Work with clinical management to develop a standard revenue capture protocol across all patient revenue areas, mapping the process from patient appointment, scheduling, and order entry through revenue recognition, collection, and reconciliation.
  • Participate in compliance investigations for inaccurate charging and assist in the development of plans to resolve issues and spread best practices.

Oversee the Health Information Management department

  • Monitor medical record deficiency and delinquency rates and provide statistical information and reports to committees and medical staff office; Manage daily revenue cycle functions pertaining to coding functions
  • Monitor proper medical record management and involvement in the EHR to ensure clinicians, patients and third party payors receive the appropriate records when necessary.
  • Provide leadership and guidance to the HIM manager in talent acquisition, development and retention. Ensure the HIM manager has a specific succession plan in place and all stakeholders have defined career development plans in place.

Oversee financial aspect of New Service development and implementation:

  • Work with hospital leadership in line with strategic initiatives, providing financial oversight for new service development and revenue generation resulting from those new services.
  • Educate and assist clinical leadership in developing new service lines and providing CDM management for new revenue generation.
  • Ensure CDM management is in place for all new services prior to implementation to guarantee appropriate revenue capture.
  • Develop reimbursement models for new service lines.

Monitor and ensure Physician claims management and revenue generation:

  • Identify potential gaps in physician and facility utilization patterns, deviations in CDM standard policy and other related coding trends that may impact retrospective and future reimbursement.
  • Ensure appropriate physician documentation to maintain timely physician billing practices, increasing reimbursement and reducing late charges and denials.
  • Provide ongoing measurement of the results of these initiatives.

EDUCATION/EXPERIENCE

  • Bachelor's degree required, preferably in Business, Accounting or Finance.
  • Must have a minimum of 8 years' experience in health care revenue cycle with 2-3 years' experience with CDM maintenance.
  • Minimum of 3-5 years supervisory experience.
  • Experience in payor contracting, reimbursement, coding and compliance, and clinical operations required.

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