Director Revenue Cycle

OBJECTIVE:The primary purpose of this position is to maximize the collection of professional and technical revenue by ensuring the efficient and productive operation of Medical Business Services' (MBS) Billing Department. This includes responsibility for the following areas: prepping & assembly, coding, charge entry, insurance, payment posting, compliance, internal and external collections and customer service. Ultimately, the role is responsible for capturing 100% of collectible dollars.SPECIAL CHARACTERISTICS:This position requires a comprehensive understanding of physician professional services reimbursement and account management in a healthcare setting. The practice currently uses the software platforms GE GPMS, GE Centricity and MedInformatix. This position requires a strong working knowledge of insurance carriers, CPT, coding and documentation guidelines. Strong organizational and communication skills are essential. Also required is an ability to prioritize multiple tasks simultaneously in an occasionally stressful environment. Also required are general computer skills, typing skills and a working knowledge of Medicare Compliance and HIPAA.REPORTS TO:         CEO of MBSSKILLS DESIRED:1.   Demonstrated results orientation (a passion for excellence)2.   3+ years in physician practice billing roles3.   Line management experience4.   Bachelors or Masters degree5.   Proven critical thinker and problem solver6.   Working knowledge of managed care networks & insurance carriers7.   Working knowledge of accounts receivable functions, including CPT coding.8.   Proficiency with computers, the Internet and MS Windows.9.   Understanding of current Medicare compliance and HIPAA regulations. 10. Knowledge of medical terminology11. Strong written and verbal communication skills12. High degree of organization and attention to detailquality13. Ability to prioritize and multi-task14. FlexibilityRESPONSIBILITIES:1.   Set Billing Department objectives and obtain results. Be a resource for, and role model to, staff and department managers. Teach, train, and coach, as necessary.2.   Ensure compliance with state and federal laws, third party payer regulations, and other pertinent regulatory bodies (Medicare, OSHA, HIPAA, etc.).3.   Oversee monthly reporting and financial analysis of Billing Department activities.4.   Oversee the workflow and day to day activities of each section.5.   Proficiency with all facets of the medical practice management system including patient registration, charge entry, insurance processing, advanced collections, reports and ledger inquiry.6.   Work with billing managerssupervisors to:·        Distribute work to optimize performance·        Interview and hire new staff members·        Monitor attendance and complete payroll·        Engage in disciplinary action, as necessary·        Conduct performance appraisals·        Provide hands-on assistance, as necessary (working manager)7.   Oversee:·        Provider insurance credentialing·        Billing platform maintenance·        Setting up new insurances·        Updating fee schedules·        Creatingupdating claim adjustment codes·        Creatingupdating claim status·        Assisting with streamlining of processes·        Posting of all credit and debit adjustments to patient accounts·        Insurance claim follow-up·        Follow-up on all returned claims, correspondence, denials, account reconciliations and rebills·        External collection agency relationship8.   Monitor reimbursement from managed care networks and insurance carriers to ensure reimbursement consistent with contract rates9.   Service existing MBS customers.10. Recommend strategic projectsinitiatives to CEO that support growth, efficiency, andor innovation11. Create a template to track quality and productivity·        Set minimum standards of performance·        Implement quality improvement initiatives12. Maintain an organized, efficient and professional work environment13. Other duties as assignedPERFORMANCE MEASURES:·        Ensure billing and coding compliance at all times·        Optimize cash to bank·        Exceed MBS budgeted net income·        Exceed gross charge goals·        Exceed charge entry timeline goals·        Exceed cash collection (payment) goals·        Exceed MBS net income goal·        Exceed AR days goals·        Exceed AR > 120 days goals·        Keep customer service phone call and mail backlog at zero·        Ensure each staff position has a trained back-up·        Ensure adequate staffing (in numbers and technical skill set)Employment in this position will be conditioned on satisfactory results of a criminal background check as determined by Minneapolis Radiology.

Created: 2025-02-21