Director | Operations | Revenue Cycle Management |
Current Management oversight of all business related functions of the patient visit from point of entry to accurate adjudication of the patients’ accounts Specific areas of responsibility include Revenue Cycle Training, Credentialing Registration, Claims Management, Billing, Collections, Patient Insurance, Data Processing, Integrity of Patient Accounts, Accounts Receivable Management, practice management system file maintenance, and third party revenue cycle vendors. Responsible for provider reimbursement programs, policies, and strategies to ensure unit cost controls meet or exceed corporate objectives for medical cost containment. It includes: Analyzes claims, utilization, medical cost data, Develops strategic, cost effective programs, and makes system or network changes to enhance competitive position. Monitors aged accounts and verifies appropriate collections procedures are being followed, manages revenue cycle projects at the Practice level, such as audits and budgets. Regularly provides upper management with revenue cycle status including reports, metrics, and presentations. Develops, monitors, and assesses business metrics in order to refine processes and improve efficiencies. Establishes internal goals and identifies external benchmarks Resolves escalated reimbursement issues with Payers, Practice, US Oncology, and systems for optimal management of accounts receivable. Develops, implements, and maintains the Practice’s revenue cycle standard operating procedures(SOPs).
