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)
MINIMUM QUALIFICATIONS:
High school diploma or equivalent and (5) years of medical billing and complex multi-specialty coding experience required. Certification from AHIMA – CCSP, AAPC – CPC, CMC, or related certification as approved by department leadership
PREFERRED EDUCATION / EXPERIENCE:
Experience with/in EPIC, Physician Billing / Hospital Billing, Revenue Cycle, Coding, Charge Capture, Medicare, and/or CMS
JOB SUMMARY:
Provides professional coding and documentation education to providers and coders within UTMB to increase coding compliance and consistency in documentation and coding guidelines. Position is responsible for coordination of all aspects of provider, practice, and coder education, including but not limited to scheduling, tracking, follow-up, and workflow integration. In addition, position works closely with QA Auditing team to determine education opportunities via denial trends, audits, and guidelines from all third-party payers.
ESSENTIAL JOB FUNCTIONS:
• Manage relationship with providers / departments within UTMB for the education of providers to increase coding compliance and consistency in documentation and coding guidelines.
• Coordinate and present education of providers, practices and coders related to risk adjustment, coding and documentation.
• Review and distribute QA reports to departments and the billing providers on an annual basis.
• Create all educational materials and track all educational activities
• Track all trends and patterns of providers, departments, clinics, and coders for coding and documentation education opportunities.
• Meets with QA auditing team to review audits to determine coding and documentation education opportunities.
• Actively participate in team functions such as team meetings, educational sessions, and team projects to promote teamwork and consistency in communication.
• Adheres to internal controls and reporting structure.
KNOWLEDGE / SKILLS / ABILITIES:
• Proficient written, oral communication and presentations skills.
• Experience in Excel and report analysis.
Equal Employment Opportunity
UTMB Health strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. As a VEVRAA Federal Contractor, UTMB Health takes affirmative action to hire and advance women, minorities, protected veterans and individuals with disabilities.
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