Sr. Revenue Cycle Advisor (Analytics / Denials / AR)

General Requirements
* Strong analytical and critical thinking skills
* The ability to lead in developing solutions to difficult or complex revenue cycle situations
* Strong communication skills, must be able to persuade and influence the actions of others
* The ability to multi-task and deal with ambiguity
* Proven leadership skills with the ability to coach, develop, and mentor others
* The ability to represent with poise, professionalism and confidence
* Proven relationship skills
* The ability to control scope of expectations during delivery of results
* The desire to do meaningful work and make a difference

• This position is responsible for overseeing and maintaining expert knowledge of processes in the following key functions;

  • Charge Capture
  • Denial Management
  • AR Management

  • Health Information Management

  • Charge Description Master

  • Managed Care Contract Administration

  • Patient Financial Services

• Measures and monitors key performance metrics and delivers concise performance reporting to key stakeholders with corrective action plans for variances as appropriate.

• Maintains appropriate internal control safeguards over AR records and collection of cash.

• Maintains compliance standards for providing accurate information on facility or health system billings.

• Identifies revenue cycle management operations and be the primary business champion within the business office.

• Reports reimbursement trends and global concerns to Executive team to ensure corrective action and mitigate future occurrences.

• Assists with the management of the revenue integrity functions including Charge Description Master Maintenance and Charge Capture activities.

• Assists in setting the strategic direction of revenue cycle and identifying areas of continuous improvement in conjunction with the leadership team.

• Maintain a current working knowledge of all related HIPAA regulations and ensures staff compliance to these requirements. This includes updating work processes, system capabilities, and policies and procedures as well as training staff on these requirements.

• Maintain a strong knowledge of insurance billing and reimbursement procedures and regulations related to insurance billing and collections.

• Assist in the development and monitoring of quality and productivity metrics and benchmarks for the hospital revenue cycle billing and reimbursement functions based on industry standards.

• Conduct financial analysis of KPIs including payer denials, A/R trends, "Unbilled Accounts" still in an unbilled status to ensure timely processing.

• Meet one-on-one and invest time with Hospital and Professional Revenue Cycle leaders; get to know them, their functional areas and what they are working on.

• Complete performance assessment of direct reports and identify any gaps or training needs.
• Employ a collaborative style that is acknowledged by peers and senior leaders.
• Perform GAP analysis of current Billing Policies and Procedure to ensure currency of the policies and appropriateness of regulatory compliance.