Vice President of Revenue Cycle

MedData is a premier billing, coding, data management, and software development company, serving emergency medicine practices coast-to-coast with a full range of business solutions.

MedData's specially trained associates, provide personalized coding, training, feedback, and claims-processing to emergency medicine physicians and administrators.

POSITION DESCRIPTION

The purpose of this position is to promote the financial viability of the corporation by effectively managing all aspects of the corporation’s revenue cycle operations through effective communication and a positive customer service attitude.  This includes day-to-day management of departmental staff; modifying and maintaining policies; continually seeking mechanisms to streamline and automate processes; and building and maintaining client and payor relationships.

 

ESSENTIAL DUTIES AND RESPONSIBILITIES

1.  Develop, implement, and manage efficient and effective operational policies, processes and best practices within functions of the revenue cycle which include provider enrollment, pre-registration, charge capture, claims processing, payment posting/credit balance management, third-party follow-up and patient A/R management.

2.  Build consensus on major revenue cycle changes and new policy with management prior to implementation. 

3.  Implement organization-wide projects, as assigned, for realizing improvement opportunities in revenue cycle operations.  Develop action plans and Return On Investment (ROI) plans for implementation.

4.  Assist in evaluating purchases, contracts and services provided by external vendors to ensure best pricing and effective results (collection agencies, claims/statement vendors, reference tools, software tools, etc).

5.  Develop and enforce corporate policies regarding account adjustments and write-offs in collaboration with CFO and COO. 

6.  Maintain knowledge of GPMS and EDITS+ and their capabilities.  Identify and implement ways to automate and streamline revenue cycle processes by maximizing GPMS, EDITS+ and other system utilization.

7.  Develop and manage department budget and monitor performance against budget.

8.  Ensure operational processes and use of GPMS, EDITS+ and other systems support accurate data collection that will provide meaningful management reporting tools for improving the revenue cycle.

9.  Set annual goals for revenue cycle performance and report departmental performance around goals to the COO.

10.  Participate on the Compliance Committee, which governs the organization’s actions and decisions regarding corporate billing compliance with regulatory guidelines and requirements.

11.  Participate in various IT-related steering committees for information technology changes which affect the revenue cycle and lead project groups as assigned.

12.  Routinely conduct payer trend analysis to ensure optimal reimbursement, identify issues, and communicate findings.

13.  Monitor administrative effects of insurance contracts on the revenue cycle.  Communicate contracting issues and proposed resolutions to the CFO.

14.  Ensure compliance with federal and state laws specifically pertaining to the revenue cycle by analyzing internal policies and implementing appropriate changes.

15.  Set standards and provide guidance to staff for maintaining exceptional customer service to patients.    

16.  Provide guidance and billing updates to departmental billing managers and coders.

17.  Provide timely communication on changes in third party payer requirements / billing policies to appropriate personnel throughout the organization.

18.  Assures work area meets the requirements of Med-Data's policies and is consistent with Federal and state patient privacy regulations such as the Heath Insurance Portability and Accountability Act of 1996 (HIPAA)

19.  Other duties as assigned

 

QUALIFICATIONS AND REQUIREMENTS

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 abilities.



1. Bachelors Degree in business or health care administration or related field.  Insurance law, CPT & ICD-9 coding, and physician billing knowledge and continuing education courses extremely helpful

2. 10 years work experience in a large, multi-specialty physician group practice or faculty practice plan environment dealing with Revenue Cycle Operations or software billing organization

3. Ability to interact with tact and diplomacy with individuals from a variety of backgrounds and organizational levels

4. Must have a customer service attitude toward organization to build positive relationships with the organization, clients and payors

5. Ability to effectively communicate both in writing and verbally

6. Excellent presentation skills

7.  Demonstrated PC skills, i.e. proficient with MS Office products including Word, Excel, Power Point and Outlook

8.  Ability to multi-task; excellent organizational and planning skills required

9.  Strong analytical and problem solving skills

10. Ability to travel as needed

 

**Telecommuting is an option for the right candidate(s).  Candidate(s) interested in telecommuting must meet our company’s telecommuting standards.