MAJOR RESPONSIBILITIES / ESSENTIAL FUNCTIONS
Position Overview :
The Executive Director of Revenue Cycle (EDRC) will work closely with the Chief Financial Officer (CFO) to provide strategic leadership and oversight of day-to-day operations of hospital's revenue cycle process. This role will manage key functions of the Revenue Cycle process including but not limited to, Patient Access, Patient Financial Services (PFS), Health Information Management (HIM), Clinical Documentation Improvement (CDI), Charge Capture, Compliance and Operations Management (COM), Contracting, Accounts Receivable (AR) Management, and Denials and Appeals Management. The EDRC will identify opportunities for process improvements and collaborate across departments to address systemic issues, ensuring the hospital's revenue cycle is operating at its full potential.
Essential Responsibilities :
- Revenue Cycle Oversight : Manage the overall revenue cycle process, including billing, coding, AR management, and collections, ensuring that each area operates efficiently and accurately.
- Process Improvement : Identify opportunities to streamline workflows, improve revenue capture, reduce errors, and enhance operational efficiency across all revenue cycle departments.
- Compliance and Regulatory Management : Ensure compliance with state and federal regulations, including Medicare, Medicaid, and commercial insurance billing requirements. Stay informed about regulatory changes that impact revenue cycle processes.
- Team Leadership : Lead and support a team of staff across various departments within the revenue cycle. Provide training, development, and performance management to ensure the team meets departmental goals and standards.
Job Description
AR Management and Collections : Oversee the management of accounts receivable, ensuring timely and effective collection of payments and addressing any issues related to outstanding balances or denials.Collaboration with Leadership : Work closely with the CFO and other senior leaders to provide insights into revenue cycle performance, identify areas for improvement, and contribute to long-term strategic planning.Reporting & Analysis : Monitor key performance indicators (KPIs) related to revenue cycle performance and prepare regular reports for leadership to assess progress and make data-driven decisions.Denials and Appeals : Manage the denial management process, ensuring that denials are addressed in a timely and effective manner. Work with the team to implement corrective actions to minimize future denials.New Service Line Support : Assist in the implementation of revenue cycle processes for newly established service lines or clinics, ensuring proper billing, coding, and compliance from the outset.Budget Management : Assist in the development and management of the revenue cycle budget, ensuring cost-effectiveness and alignment with organizational objectivesJOB QUALIFICATIONS
Minimum Education
Bachelor's degree in Accounting, Finance, Business Administration, or Healthcare Administration required.Preferred Education
Master's degree in Business Administration (MBA) or Healthcare Administration preferred.Minimum Work Experience and Qualifications
A minimum of 10 years of experience in an acute care hospital setting, with at least 5 years managing revenue cycle operations.Extensive experience in all aspects of revenue cycle management, including billing, collections, AR, denials, charge capture, contracting, and coding.Demonstrated experience in process re-engineering, workflow design, and AR deficiency management.Strong knowledge of regulatory requirements, including Medicare, Medicaid, and commercial insurance guidelines.Minimum of 5 years in a leadership role, managing a diverse team and driving operational excellence.Preferred Work Experience and Qualifications
Strong analytical and financial management skills.Exceptional leadership and team management abilities.Ability to communicate effectively both verbally and in writing.Knowledge of healthcare regulations and payer requirements.Ability to manage multiple priorities in a fast-paced environmentRequired Licensure, Certification, Registration or Designation
Current Los Angeles County Fire Card required (within 30 days of hire)Assault Response Competency (ARC) required (within 30 days of hire)Shift : Day
Weekly Hours : 40
Type : Exempt
FTE : 1.0
