As the Director of Anesthesia RCM, you will be flexible and integrate multiple lines of business into your sphere of responsibility. You will work at a strategic level while also having the ability to dive deep into issues to support resolution. This position will be responsible for leading Anesthesia RCM activities to include Billing, Collections, Revenue Integrity auditing, charge master management, medical claims management (including denials and appeals operations), cash application and other various other back-office functions. You will be responsible for building a team, developing and implementing strategies, processes, and technology to continuously improve and manage the revenue cycle in a fast-paced, high-volume, evolving healthcare market.
What You Will Be Doing:
- Running reviews, interpreting, analyzing, and validating Revenue Cycle reports.
- Ensuring the integrity of data provided to all areas of the revenue cycle and other areas of the organization.
- Leading the development and implementation of Anesthesia revenue cycle strategies and initiatives to continuously improve the RCM process and maximize the company’s billings and collections.
- Identifying, analyzing, and implementing solutions designed to improve collection rates, reduce bad debt, and reduce day sales outstanding.
- Driving the design, execution, monitoring, and assessment of key Anesthesia RCM performance metrics to refine processes, improve efficiencies and productivity to reduce overall costs.
- Leading and managing large revenue cycle projects such as audits, budgets, and technology enhancements.
- Managing vendor relationships and vendor-related projects, working with service providers to deliver agreed-upon results and facilitating and coordinating change management efforts.
- Driving cost, quality, and process improvement by establishing well-defined processes, sharing best practices, and ensuring effective working relationships.
- Creating Anesthesia RCM efficiencies through system selection/automation, process design, and avoiding waste/redundancy in order to deliver continuous improvements.
- Ensuring compliance in all aspects of Anesthesia RCM activities, including coding and billing rules and regulations by payer and state.
- Maintaining knowledge of third-party payor regulations including Medicare, Medicare Advantage, Medicaid, Workers Compensation and non-governmental payers.
- Adhering to all internal Corporate Compliance guidelines, OIG, government healthcare regulations, regulatory policies and procedures, and privacy and security standards in accordance with government agencies, including HIPAA requirements.
What You Need To Have:
- Minimum of 5+ years of experience in healthcare reimbursement (RCM).
- 3-5 years of experience managing people or leading teams required.
- Vendor management experience required.
- In-depth knowledge of the healthcare industry, anesthesia, payer relations, and functional compliance regulations and standards required.
- Demonstrated organizational and communication skills and ability to work with accuracy and confidentiality when dealing with detailed financial information.
- Demonstrated communication skills with a variety of audiences, including department management, organizational leaders, physicians, and staff members using presentations, spreadsheets, and written documents.
- Data analysis and modeling capabilities in Excel & Power BI
- Strong organizational, analytical and statistical skills
- Ability to multi-task and work both independently and within teams
- Strong understanding of business strategies and drivers, particularly in a sales organization.
- Excellent interpersonal and customer service skills.
- Excellent time management skills with a proven ability to meet deadlines.
- A professional, outgoing, warm and collaborative attitude
- Bachelor’s Degree in Healthcare Administration, Business, Finance, or related field required.