JOB SUMMARY: Evaluates revenue cycle performance operations, independently. Ensures appropriate reimbursement of professional and technical services for multiple areas.
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
Core Duties
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.
*CA
*IND000
Internal Number: 1904736
About Vanderbilt Health
Vanderbilt University Medical Center is home to Vanderbilt University Hospital, The Monroe Carell Jr. Children’s Hospital at Vanderbilt, the Vanderbilt Psychiatric Hospital and the Vanderbilt Stallworth Rehabilitation Hospital. These hospitals experienced more than 61,000 inpatient admissions during fiscal year 2015. Vanderbilt’s adult and pediatric clinics treated nearly 2 million patients during this same period.Vanderbilt University Hospital and the Monroe Carell Jr. Children’s Hospital at Vanderbilt are recognized again this year by U.S. News & World Report’s Best Hospitals as among the nation’s best with 18 nationally ranked specialties. Vanderbilt University Medical Center is world renowned because of the innovation, work ethic and collegiality of its employees. From our health care advances to our compassionate care, Vanderbilt owes its accomplishments and reputation to staff and faculty who bring skill and drive and innovation to the medical center day after day. World-leading academic departments and comprehensive centers of excellence pursue scientific discoveries and transformational educational and clinical advances across the entire spectrum of health and disease.As th...e largest employer in middle Tennessee, we welcome those who are interested in ongoing development in a caring, culturally sensitive and professional atmosphere. Most of us spend so much of our lives at work, we want to be part of maintaining a workplace in which people support one another and encourage reaching for excellence. Many high-achieving employees stay at Vanderbilt because of the professional growth they experience and because of their appreciation of Vanderbilt’s benefits, public events and discussions, athletic opportunities, beautiful setting and, above all, sense of community and purpose.Vanderbilt and its employees share a set of mutual expectations that have been created with productivity, legality, fairness and safety always in mind. We believe that our investment in training and compensating employees multiplies in value when we enable individuals to deliver their best performance for the benefit of us all.
