Description

The Vice President of Revenue Cycle Management will work to help new Practices, as well as established ones, realize improved performance through embracing developed Policies and Standard Procedures, and oversee the Central Business Offices and Third Party Contracting. In particular, this individual will ensure each practice follows best practices in revenue cycle management, conducts monthly reviews to ensure that goals are met, and helps the practice negotiate the best possible contract and reimbursement with third-party payers.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

Responsibilities

Leadership

• Develops a relationship between the Practice and Central Business Office(s) that fosters trust and a collaborative approach
• Develop a relationship through which physicians and staff embrace policies and stand procedures
• Develops a relationship and contracts with Third Party Payers (insurances) that are in the best interest of our practices
• Participates in the development and delivery of PSPs that promote excellence, superior patient care experience and improved performance
• Assures the establishment of feedback loops through quality improvement strategies/programs to continually improve and refine processes
• Demonstrates excellence in leadership as demonstrated by guiding the Practices to continual higher levels of performance in patient care and financial results
• Fosters a positive working environment for staff; attracts and retains motivated employees and appropriately rewards positive results
• Demonstrates strong relationship management skills that provide for handling challenging interpersonal situations respectfully and gracefully
• Identifies and pro-acts to potential issues that will impede success

Planning and Execution

• Develops a dynamic and cost effective Central Business Office(s) that can be leveraged by all partners practices to conduct payment posting, A/R Management, Cash Managements, Patient Customer Service
• Develops Policies and Standard Procedures that improve performance at the practice
• Negotiates contracts with Third Party Payers to acquire the best possible contract and reimbursement
• Leads/participates in monthly RCM meetings to provide continuous feedback on gaps, sub-optimal performance, and inefficient workflow/processes
• Conducts Reimbursement Analysis to ensure contractual reimbursements are met
• Monitors and implements third party contractual changes with practices

Collaboration and Teamwork

• Collaborates with the practices, Central Business Office(s) and Practice management team to ensure that best practices are implemented
• Acts as liaison between the Practice and the billing system to educate how the PSPs will fill identified gaps in processes
• Acts as a liaison between the Practice and Third-Party Payers to resolve contractual issues, negotiate new contracts and re-negotiate existing contracts
• Assists, supports and manages efforts to ensure that the Central Business Office(s) operates in full and complete compliance with all regulatory bodies

Communication

• Demonstrates effective interpersonal problem solving, as well as written/verbal communication skills
• Maintains continuous communication with Practice, Central Business Office and Home Office to ensure that RCM Goals are met or Third-Party Insurance Payer issues are being addressed in a timely manner

Functional Areas

• Performs Practice and Central Business Office(s) assessments to eliminate or minimize slippage of performance (i.e. not following PSPs)
• Manage in a complex environment involving several parties with each one’s accompanying policy and regulatory requirements

Additional Areas of Responsibility

• Manages the Central Business Office (CBO) activities, maintains a strong working relationship with the practice to ensure high quality of service is being delivered to the practices and patients

Requirements

 Skills & Requirements

• Bachelor’s degree or Masters in healthcare administration is preferred
• Minimum of four to seven (4-7) years leadership experience in managing Central Business Offices and Insurance Contracting
• Understand the principles of Policies and Standard Procedure
• Embrace collaboration as essential to success
• Engage in open, respectful and ongoing communication
• Solicit and use creativity to drive enhancements
• Use common sense in development solutions
• Act with ethical integrity
• Focus on outcomes, Execute tasks, Measure results