Revenue Integrity Director in Eden Prairie, MN at APEX Systems

Date Posted: 6/14/2018

Job Snapshot

Job Description

Job #:  857760

Title: Revenue Integrity Director 

Start date: ASAP

Duration: 3-6 months; potential contract to hire if the right fit.

Location: Connecticut preferred;  Travelling each week onsite at Uconn subject to client needs.

 

Project Summary:

University of Connecticut has been engaged to perform Revenue Cycle Transformation with the goal of increasing cash flow and developing a long term revenue cycle partnership.  Ideal candidates will have experience in multiple functional revenue cycle areas which include Patient Financial Services, Patient Access with a focus on Revenue Integrity.

The RCM team conducted an assessment early in 2018 and determined areas of opportunity in the following high level work streams:

• Billing, Collections and Insurance Follow Up

• Financial Counseling

• Cash Posting Management

• Registration and Pre-Authorization

• SBO (Single Billing Office) / Self Pay Customer Service

• HIM Coding, Document Management, Transcription & Release of Information

• Physician Education, Documentation (CDI) and Coding Compliance

Initial phase consists of the following:

• Interim Management

• Revenue Cycle Consulting to drive $10M in revenue improvement – $500K at risk for $6M in benefits.  Areas of focus:

o Denials/DNFB

o CDM/Charge Capture

o Revenue Integrity

• KPI's to measure success

 

Role Description

This Revenue Cycle Consultant will serve as an Interim Revenue Integrity Director and industry expert while implementing best practices.  The resource must have a good combination of leadership, experience and understanding of solutions to bring world class results to Revenue Integrity at the client including but not limited to:

• Assessing the customer charge master and charging process

• Assessing the impact of new technologies on specific workflow and identify the associated education needs, system remediation needs and workflow redesign

• Identifying potential performance improvement opportunities or best practices and make recommendations to client on how to integrate new process/best practice into current workflow

 

Principal Responsibilities

o Provide consulting services to clients in all areas of the healthcare revenue cycle with a focus on the charging process

o Understand clinical coding scenarios for hospital ancillary departments (e.g., Radiology, Laboratory, Pharmacy, Rehab)

o Understand hospital and physician Medicare and Medicaid billing and coding

o Understand governmental and third party reimbursement policies

o Ability to write a monthly newsletter and present quarterly to clients

o Ability to understand complex billing and coding requirements and educate clients on them

o Understand and represent client technology and services and how they will improve client operations.

o Develop work plans, project tasks and manage projects in accordance with budget.

o Document findings, impacts and recommendations within assessment deliverables; responsible for the revenue cycle sections within each deliverable

o Identify client barriers in achieving operational excellence

o Understand client business metrics and results

o Evaluate and analyze client data to understand trends in all areas of the operation

o Development of options and recommendations for client improvement

o Collaborate with client revenue cycle team and other departments in order to facilitate resolution of process issues and implement world-class solutions.

o Provide informed feedback to client executives including assessments of processes, standards, suggestions and improvements

o Provide interim staffing services as required

 

Qualifications

o Bachelor's Degree preferred

o Master's Degree in Business Administration or related field preferred