Director Rev Cycle Mgmt

Description

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Position: Director Revenue Cycle Management 

Entity: Clinical Practices of the University of Pennsylvania (CPUP) 

Department: Ortho Administration 

Location: Penn Medicine University City- 3737 Market St 

Hours: Full Time, Per Departmental Needs 

Summary: 

The Revenue Cycle Director is responsible for overseeing all revenue activities and organizing strategies to increase profitability and meeting all financial objectives. They will review practice billing activities and generate ideas for innovative revenue programs. Areas of oversight include but are not limited to practice revenue cycle operations including pre-registration, financial clearance, documentation, coding, charging, and billing and collections practices. This position will analyze and review all departmental work queues for accuracy and timely competition. Promote and evaluate key performance indicators including but not limited to, self-pay collection rates, bad debt, charge lag, claim edits, and enrollment edits.

The Director will maintain a good working relationship with Directors of Operations and Director of Finance to ensure ongoing financial and operational performance to ensure clear communication and effectively interact with patients, as required, and other team members while maintaining a high standard of excellence and professionalism. Provide counsel to the COO, Division Chiefs, Physicians, Professional Fee Abstraction Department, the Professional Billing Office, Hospital Billing Office, and additional committees and organizations as directed. Work closely with other departments and Revenue Cycle leadership to translate improvements to other areas. 

Responsibilities: 

• Define strategic objectives, work closely with internal stakeholders and revenue cycle business partners to evaluate and analyze existing systems and processes, and implement improvements that support revenue cycle goals.
• Ensures compliance with federal and state legal requirements by researching existing and accessing new legislation and by consulting with outside advisors. 
• Completes all regulatory and company documentation and reporting in accordance with established and /or required schedules. 
• Advises management of actions and potential risks. 
• Works proactively and closely with the compliance team on regulatory and credentialing matters impacting revenue cycle processes and develop strong relationships with payers and health plans to ensure streamlined problem resolution and maximized opportunities. 
• Respond to inquiries related to insurance billing concerns, collection law and insurance protocol escalated by billing team staff. 
• Ensures the maintenance and updates the hospital’s Charge Description Master occurs in coordination with all departments and is a resource to leadership for research on charge issues. 
• Provide reporting and feedback to various hospital departments for correct coding and billing of patient accounts and manages outside audit, reporting, and special program requirements. 
• Prepare staffing and operations budget projections annually. Ensure department operations expenses are maintained within budgeted projections. 

Education or Equivalent Experience: 

• H.S. Diploma/GED (Required) 
• Associate of Arts or Science in Healthcare Administration or related field AND 10+ years relevant management experience, including 7 years of related experience working in healthcare (Required)
• Master of Arts or Science (Preferred) 

Skills & Abilities: 

• At least 7+ years’ experience in professional revenue cycle setting, and responsibility within healthcare business operations (Required). 
• Knowledge of patient registration, scheduling, authorizations, billing process and workflow (Required). 
• Experience with accounting, financial statements, and revenue cycle operations (Required). 
• Basic knowledge of EHR programs, Medical Terminology, ICD-10, CPT, HCPCS codes and coding processes (Required). Strong understanding and comfort level with computer systems and experience with process improvement methodologies (Required). 
• Thorough understanding of healthcare reimbursement and denial management processes (Required). 
• Previous staff management experience (Preferred). 

Excellent inter-personal, verbal, and written communication skills (Preferred). 

Demonstrated ability to successfully lead process improvement projects (Preferred). 

Demonstrated analytical skills (Preferred).

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

Live Your Life's Work

We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.