Director, Revenue Cycle and Operations

Benefits

Additional Information

The Director oversees and is accountable for all business facets of the practice, which encompasses revenue cycle and clinical business operations. The Director will supervise the daily management of the medical group concerning all elements of billing and Accounts Receivable management, as well as front office clinic operations. The Director is tasked with the creation and execution of all policies, procedures, and standards by initiating and developing systems that influence operations to comply with all contracting, Medicaid, Medicare, and HCFA requirements. The Director will also be responsible for assembling the suitable administrative team to fulfill the objectives established for the practice group regarding revenue cycle management. Essential Functions (Principal Duties and Job Responsibilities): Accountable for overseeing, directing, coordinating, and regulating all daily operations related to the physicians' billing, accounts receivable management, and clinical functions for the Meharry Medical Group and Total Health. Reviews and offers guidance to the contracted billing vendor or central billing office to guarantee that all provider billings are processed promptly and accurately, and that all accounts receivable are pursued in a similar fashion. Establishes accounts receivable policies and practices aimed at billing and collecting patient accounts and other revenue sources in a timely manner, reducing uncollectible accounts, maximizing cash flow, and preserving community goodwill. Develops, implements, and maintains objectives, procedures, and standards to optimize revenue; analyzes reimbursement and payment regulations for physician services to ensure compliance with HMO contracts and HCFA guidelines for teaching physicians. Continuously evaluates the work methods and systems impacting physician billing, offers timely and effective recommendations for workflow improvement, and executes approved modifications. Cultivates effective communication channels with physicians through ongoing committee and department chair meetings, a policy and procedure manual, and monthly newsletters. Delivers revenue cycle and financial reporting packages to the Senior Vice President of Health Affairs, Associate Dean of Business and Finance, School of Medicine, and other members of the Meharry Medical Group clinical leadership team. Collaborates closely with the Associate Dean of Business and Finance of the School of Medicine on quarterly Board Reports. Supervises educational training for physicians and their staff regarding the appropriateness of procedural and diagnostic coding. Ensures compliance with all legal and regulatory requirements by staying informed of changes and implementing necessary controls and/or programs to meet these requirements. Guarantees that the flow of data, documents, and information critical to operations is efficiently organized, coordinated, and adheres to city, state, and federal regulations. Compiles reports and conducts audits as needed. Prepares, reviews, and submits the annual operating budget; monitors and ensures compliance with. Assists faculty in preparing for managed care and risk-based contracting by providing education and developing related policies and procedures in collaboration with the leadership of Meharry Medical Group. Aids the Senior Vice President of Health Affairs, medical directors, MMG leadership, and faculty representatives in the creation and oversight of managed care and risk-based contracts. Offers support to the Senior Vice President of Health Affairs, Department Chairpersons, and Committees in formulating operational processes for the execution of clinical/medical policies, which include practice and referral guidelines, peer review standards, utilization review policies, and quality assurance initiatives. Collaborates with the Senior Vice President of Health Affairs to establish a working relationship with senior management staff at Metro General Hospital and other hospital systems to facilitate and coordinate billing, medical records, compliance, and physician-related issues concerning patient care and services. Ensures the efficient operation of all clinical front office activities, including the call center, registration, front desk exit processing, front office operations, billing, coding, medical records, and compliance. Oversees the implementation of training programs focused on customer/patient satisfaction, eCW utilization, coding, medical record documentation, and all pertinent policies and procedures. Engages in negotiations with insurance companies, external vendors, and others to guarantee that MMC secures the most favorable reimbursement/pricing on relevant contracts. Provides senior leadership with monthly reports (and on a need-to-know basis) that detail the financial, compliance, and programmatic status of relevant programs and services. Takes the initiative on additional responsibilities such as ensuring HIPAA compliance. Develops, imple