Revenue Cycle Director directs and oversees the overall policies, objectives, and initiatives of an organization's revenue cycle activities to optimize the patient financial interaction along the care continuum. Reviews, designs, and implements processes surrounding admissions, pricing, billing, third party payer relationships, compliance, collections, and other financial analyses to ensure that clinical revenue cycle is effective and properly utilized. Being a Revenue Cycle Director tracks numerous metrics related to the patient engagement cycle including record coding error rates and billing turnaround times to develop sound revenue cycle analysis and reporting. Manages relations with payers and providers to generate high reimbursement rates and a low level of denials. Additionally, Revenue Cycle Director requires a bachelor's degree. Typically reports to top management. The Revenue Cycle Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. To be a Revenue Cycle Director typically requires 5+ years of managerial experience. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. (Copyright 2024 Salary.com)
The Alaska Native Tribal Health Consortium is a non-profit Tribal health organization designed to meet the unique health needs of Alaska Native and American Indian people living in Alaska. In partnership with the more than 171,000 Alaska Native and American Indian people that we serve and the Tribal health organizations of the Alaska Tribal Health System, ANTHC provides world-class health services, which include comprehensive medical services at the Alaska Native Medical Center, wellness programs, disease research and prevention, rural provider training and rural water and sanitation systems construction.
ANTHC is the largest, most comprehensive Tribal health organization in the United States, and Alaska’s second-largest health employer with more than 3,100 employees offering an array of health services to people around the nation’s largest state.
Our vision: Alaska Native people are the healthiest people in the world.
Benefits include:
or contact Recruitment directly at HRRecruiting@anthc.org.
Alaska Native Tribal Health Consortium has a hiring preference for qualified Alaska Native and American Indian applicants pursuant to P.L. 93-638 Indian Self Determination Act.
Summary:
Responsibilities:
Develops and implements departmental goals and objectives that are consistent with the overall strategic plan. Prepares a plan to achieve the departmental goals and objectives. Conducts periodic review and evaluation of the plan to ensure progress and implements changes when necessary. Coordinates system-wide activities assuring consistent application of strategic initiatives. Develops strategy and collaborates with Administration, physicians, operating units and payers to ensure compliance with documentation requirements for federal and state regulatory agencies and accrediting agencies. Responsible for work redesign efforts of process improvements achieved by enhanced use of automated systems, both existing and pending installation, that support the critical outcomes expected to contributing to the overall strategic plan.
Plans, develops and administers annual budget and provides current and forecasted information and supportive data with respect to material, salaries, equipment and operational changes. Investigates and justifies significant variances. Responsible for the development of industry standard targets and measures to assure appropriate departmental productivity, quality and customer relationships. Manages departmental projects and contracts. Determines appropriate placement and use of current and health information technology. Supports information system initiatives for the department and its customers. Represents health information at divisional and organization –wide planning and quality improvement initiatives and committees. Coordinates TSMS information services with management of the Indian Health Services (HIS) medical records. Utilizes health information knowledge, management theory, and organizational skills in accomplishing goals. Knowledgeable of the role of medical records and the department in patient access, clinical documentation, revenue cycle management, corporate compliance (including HIPAA, JCAHO, etc.), documentation, patient safety and computerization.
Collates, analyzes and provides clinical and demographic data and/or other statistics for studies and research as a basis for projection of future patient care and operations. Monitors and analyzes federal and state regulatory requirements and proposed legislation and accrediting agency standards for compliance. Implement changes or effects change, as necessary, to comply with regulatory or accrediting agency changes. Makes recommendation and manages the implementation of changes in procedures throughout the health information services cycle. Establishes and maintains a Quality Improvement Program for the department, integrated with the overall institutional Quality Improvement Program. Serves as administrative liaison for resource management projects and activities. Monitors customer service through periodic monthly management meetings, supervisory reports, on-site procedure audits and results of external assessments.
Provides leadership, direction, and guidance to assigned staff. Develops goals and priorities in conjunction with employees, and assigns tasks and projects. Develops staff skills and training plans. Counsels, trains, and coaches subordinate staff. Implements corrective actions and conducts performance evaluations.
Other information:
KNOWLEDGE and SKILLS
Knowledge of health information management principles, practices, techniques, concepts and policies.
Knowledge of Alaska Tribal Health System, local, state, federal and Tribal statutes, rules, regulations, and operational guidelines and directives; and accrediting agency standards (i.e., JCAHO).
Knowledge of medical terminology and abbreviations; anatomy and physiology; major disease processes and pharmacology.
Knowledge of classification systems, including CPT-4, E&M, ICD-9-CM, ICD-10-CM and HCPCS nomenclature, coding rules and guidelines, and various EMR/EHR and other practice management products.
Knowledge of clinical workflow and coding conventions and rules established by the American Medical Association (AMA), the Center for Medicare and Medicaid (CMS), AHIMA, for assignment of diagnostic and procedural codes.
Knowledge of the Privacy Act of 1974 and HIPAA Privacy Rule Act of 1996, other current medical legal issues, laws and regulatory agencies, including HITECH Act.
Skill in effectively managing and leading staff, and delegating tasks and authority.
Skill in assessing and prioritizing multiple tasks, projects and demands of varying degrees of sensitivity and confidentiality.
Skill in resolving complicated service issues using independent judgment and initiative.
Skill in understanding medical billing procedures and protocols and revenue cycle management.
Skill in linking diagnosis to services and applying appropriate codes to diagnosis, procedures, evaluation and management, and supplies.
Skill in operating a personal computer utilizing a variety of software applications.
Skill in operating computerized medical data entry and information processing systems.
Skill in oral communication and presenting information to others, including advising leaders of complex organizational units.
Skill in writing reports and other materials.
Skill in establishing and maintaining cooperative working relationships with employees and other individuals with wide array of cultural, political, educations, and socio-economic backgrounds.
MINIMUM EDUCATION QUALIFICATION
A Bachelor’s degree in Health Information Management or related field. Progressively responsible professional work-related experience, education, or training may be substituted on a year-for-year basis for college education.
MINIMUM EXPERIENCE QUALIFICATION
Non-supervisory – Ten (10) years of responsible healthcare experience.
AND
Supervisory – Three (3) years involving employee supervision.
MINIMUM CERTIFICATION QUALIFICATION
RHIA or RHIT required, CPC or CCS-P required
PREFERRED EDUCATION QUALIFICATION
A Master’s Degree in Health Information Management or related field.
PREFERRED EXPERIENCE QUALIFICATION
N/A
PREFERRED CERTIFICATION QUALIFICATION
PMP (Project Management Professional)
ADDITIONAL REQUIREMENTS
· May be required to work outside the traditional work schedule.
· May be called out to work off-shift in emergency situations.
· According to the needs of the organization, some incumbents in this job class may be required to obtain specific technical certifications and programming language skills.
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