Company Overview

Headquartered in Atlanta, Georgia, EyeSouth Partners is a premier network of integrated eye care practices located across the country. Our affiliated ophthalmology practices benefit from superior operational expertise, as well as investments in support staff, ongoing education, state-of-the-art technology, and strategic guidance with an absolute focus on clinical quality and a patient-first culture. EyeSouth’s affiliate network consists of 40 practices with approximately 2800 employees and over 300 doctors providing medical and surgical eye care services at approximately 175 locations including 20 surgery centers throughout Georgia, Texas, Louisiana, Florida, Tennessee, Ohio, Kentucky, Pennsylvania, Alabama, Illinois, North Carolina, and South Carolina.

Position Summary

The Director, Revenue Cycle Operations reports to the CRCO and is directly responsible for the operational effectiveness of the Revenue Cycle Operations Division by managing strategic initiatives that improve overall reimbursement, collections, billing and claims, workflow processes, organizational structure, staffing decisions, and other Revenue Cycle specific initiatives. The Director, Revenue Cycle Operations will lead internal project teams, make presentations to leadership, assist with strategy development and deployment, analyze workflow processes, manage and track detailed action steps needed to complete strategic initiatives, manage and estimate operational budgets, and assist in the creation of divisional metrics, reports, and dashboards for tracking success.

Responsibilities

• Provide operational direction and leadership for areas of the Revenue Cycle Division, including professional billing/charge capture/follow-up/insurance cash application (including credits, refunds, and cash posting), revenue integrity, denials, payment variance and customer service.
• Maintain a strong knowledge of insurance billing and reimbursement procedures and federal, state, and local regulations related to insurance charging, billing and collections.
• Ensure that all Revenue Cycle activities assigned, are conducted in compliance with all state and federal regulations, and ensure staff are properly educated to accomplish this requirement, through training and written policies and procedures.
• Maintain, update as appropriate, and enforce the adherence to Revenue Cycle and system written policies, procedures, and processes.
• Develop and monitor productivity and quality metrics and benchmarks for each area of the Revenue Cycle based on industry standards. Monitor productivity and quality of each area using metrics and provide feedback to management regularly (monthly as a minimum).
• Develops leadership teams appropriate for department needs.
• Develops and implements strategic plans and budgets; monitors performance to expectations.
• Work closely with other departments (HIM, Affiliate Operations, Information Technology, Compliance, and Ancillary departments) to streamline procedures that will help ensure correct billing to patients and payers in a timely manner, thereby expediting receivables.
• Maintains strong knowledge of insurance billing and reimbursement procedures and federal, state, and local regulations related to insurance billing and collections.
• Identify opportunities for system or process improvements and drive change through targeted initiatives.
• Responsible for the effective budget development and financial performance of the department as delegated in the areas of salary expense, supply expense, and capital needs and expenditures.
• Select, evaluate, counsel, and discipline as required in a positive manner consistent with health system policies.
• Maintain a system to recognize staff informally and formally for accomplishments.
• Implement a Quality Assurance program for RCM functions and monitor staff and team performance, making changes, when required, to support accurate billing to payers and patients in a timely manner and compliance with laws and department procedures.
• Performs other duties as assigned.

Qualifications

• Minimum of (10) years healthcare revenue cycle experience in a multi-location setting required including: ICD-10,CPT, and HCPCS coding, physician practice management, or reimbursement analysis.
• Bachelor’s degree in health care administration, Business Administration, or another related field or equivalent encouraged
• Must possess strong managerial competencies in the areas of leadership and team development, managerial coaching, mentoring and situational assessment skills.
• Must be a change agent and capable of guiding the firm in initiating various change management initiatives with the view of leading and guiding the firm towards growth and development.
• Must possess strong managerial acumen in setting corporate directions and aligning strategic goals around business plans.
• Must possess superior judgement, negotiations, and decision- making skills.
• Must possess strong ethics and a high level of personal and professional integrity.
• Must possess strong analytical skills and be adept in interpreting strategic vision into an operational model.
• Must be willing to seek out new methods and principles and be willing to incorporate them into existing practices, and willing to embrace new technology.

• Exercise knowledge of the standards and regulatory requirements applicable to matters within designated scope of authority, including medical/legal issues.
• Excellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external
• Exercises sound judgment in responding to inquiries; understands when to route inquiries to next level.
• Self-motivated with strong organizational skills and superior attention to detail
• Team player that develops strong collaborative working relationships with internal partners and can effectively engage and ability to build consensus among cross-functional teams.

Company Benefits

We offer a competitive benefits package to our employees:

• Medical
• Dental
• Vision
• 401k w/ Match
• HSA/FSA
• Telemedicine
• Generous PTO Package

We also offer the following benefits for FREE:

• Employee Discounts and Perks
• Employee Assistance Program
• Group Life/AD&D
• Short Term Disability Insurance
• Long Term Disability Insurance

EyeSouth Partners is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.