Director Revenue Cycle - Hospital Inpatient and Outpatient Coding

Job Overview

The Director of Revenue Cycle Management Coding Operations leads with purpose—driving operational excellence across one or more major Revenue Cycle functions and ensuring the financial health of the organization from front to back end. In this high-impact role, you'll set strategy, leverage digital tools to maximize efficiency, and partner across the enterprise to deliver compliant, trusted outcomes for patients, providers, and the workforce. If you're ready to lead transformative change and build a high-performing team, this is your next challenge.

This position is fully remote.

Responsibilities

• Provides Strategic Direction. Performs continuous assessment to help identify strengths, weaknesses, opportunities, and threats to IP and OP Coding Functions. Identifies, evaluates, develops, and implements strategies and tactics to achieve organizational objectives.
• Oversees functions, priorities, and staff effectiveness to ensure maximum quality, efficiency, throughput, and outcomes are achieved and work is executed in a compliant, accurate and timely manner.
• Establishes performance metrics and KPI’s that align with benchmark standards and result in daily maximum output supporting strong cash flow for the organization. Ensures leaders and team alike monitor and measure performance and associated performance that result in leading practice outcomes for the organization.
• Responsible for managing effective and efficient coding operations including people, processes and technology that results in leading practice clean claim creation and submission daily. This supports strong and stable cash-flow; Leads employees and influences stakeholders to follow appropriate standards, workflow as well as a systematic improvement process.
• Provides oversight to ensure compliance with established laws, regulations, practices, and procedures. Maintains self and team knowledge of, and complies with, all relevant laws, regulations, policies, procedures, and standards
• Leads the department in financial controls that ensure fully vetted, tested, and approved people, process and technology edits and changes that result in compliant and clean claim processes. Provides subject matter expertise on technical and compliance areas that impact claims processing including EPIC HB system, and payor requirements.
• Guides and implements framework with leadership team that ensures routine evaluation of staff performance, meaningful feedback, coaching, and corrective action when necessary to support growth, development, and high performance.
• Works with leadership and team to ensure appropriate staff education, training programs and culture of diversity, equity and inclusion are in place. Identifies opportunities and works with leadership and staff to implement plans to improve staff engagement. Establishes, maintains, and ensures appropriate education vehicles for team and customers remaining current with regulations and payer requirements.
• Acts as a leader, mentor and advisor with revenue oversight taskforce teams preparing and reporting on schedules related to unbilled, and billing matters requiring attention.
• Manages department leadership and teams. Ensures organizational structure, job descriptions and performance are optimized. Hires, orients, and trains leadership team. Assures development and implementation of key productivity and quality standards for department processes. Establishes and works with leadership team to monitor, manage, and as appropriate related to productivity and quality as well as creating efficiency leveraging technology to achieve leading practice performance.
• Performs succession planning and individualized plans to provide development opportunities within the organization. Understands and follows human resource policies and procedures.
• Oversees the activities of outsourced/ partnership with external vendors including implementation and on-going performance. Represents Revenue Cycle and Fairview Health Services at industry forums to network and identify process improvement opportunities.
• Monitors Finances. Develops and monitors budgets for assigned areas. Ensures key performance indicators are monitored and being met. identifies, evaluates, and implements, as appropriate, cost reduction opportunities Meets budget expectations. Develops and manages financial forecasts for entity. Along with senior management team, accountable for closing gap between run rate and target. Plans, directs, and oversees annual budget development and ongoing management for all areas of responsibility.
• Develops Strong Working Relationships. Leads or participates in work with peers and other departments to create an excellent understanding of workflows and interdependencies, and to identify and implement strategies to improve revenue cycle performance.
• Fosters a culture of improvement, efficiency, and innovative thinking.
• Creates structures and processes within team and internal customers to continuously optimize and improve processes to mitigate delays, errors and defects that result in denials and write-offs and improve transparency of the patient’s financial journey.
• Creates and cultivates culture of analysis, trends, issues, risk and resolution tracking with team and customers to identify patterns and appropriate solutions in a timely manner
• Performs other responsibilities as needed/assigned.
• Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served
• Partners with patient care giver in care/decision making.
• Communicates in a respective manner.
• Ensures a safe, secure environment.
• Individualizes plan of care to meet patient needs.
• Modifies clinical interventions based on population served.
• Provides patient education based on as assessment of learning needs of patient/care giver.
• Fulfills all organizational requirements
• Completes all required learning relevant to the role
• Complies with and maintains knowledge of all relevant laws, regulation, policies, procedures and standards.
• Fosters a culture of improvement, efficiency, and innovative thinking.
• Performs other duties as assigned

Required Qualifications

• B.S./B.A. Bachelor’s degree. In Lieu of degree, candidate would need 4 years experience with content/technical knowledge and demonstrated capability to deliver results (this would be in addition to the experience listed below).
• 5 years related experience
• 5 years people leadership experience
• One or more of the following: RHIA, RHIT, CHRI, CCS, CPC, CCS, CPC, CCS-P, RN, CDIS, CDIP

Preferred Qualifications

• M.A./M.S. in Health Information Management or related field
• 7 years management experience in a Health Information Management department or Coding division
• 5 years coding experience
• One or more of the following: RHIA, RHIT, CHRI, CCS, CPC, CCS, CPC, CCS-P, RN, CDIS, CDIP

Benefit Overview

Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link for additional information: https://www.fairview.org/careers/benefits/noncontract

Compensation Disclaimer

The posted pay range is for a 40-hour workweek (1.0 FTE). The actual rate of pay offered within this range may depend on several factors, such as FTE, skills, knowledge, relevant education, experience, and market conditions. Additionally, our organization values pay equity and considers the internal equity of our team when making any offer. Hiring at the maximum of the range is not typical. If your role is eligible for a sign-on bonus, the bonus program that is approved and in place at the time of offer, is what will be honored.

EEO Statement

EEO/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status