The Director of Revenue Cycle will be responsible for the oversight of all revenue cycle activities, primarily within an outsourced environment, to ensure the maximum performance of revenue cycle operations for the expansive clinical enterprise within the Department of Radiology and Joint Venture(s).
This position reports to the Department Administrator / CFO and is a strategic partner working closely with the Department Directors overseeing Operation, Coding, Budgets and Financial Planning: to ensure the integrity of the revenue cycle: working with Practice Plan Director, implements policies and corrective actions to enhance the revenue cycle and specific areas of responsibility of front-end operations. Partner with the Director of Coding and Compliance to ensure all system integrations are established and ensures charge integrity. Responsible for working closely with the Directors for Finance and Budget to align revenue budgets and forecasts.
The Director Revenue Cycle will be responsible for oversight of revenue cycle operations for department. Position also will be responsible for organizational structure to accomplish all activities within the revenue cycle division, with particular emphasis coordinated and management of all business-related functions to meeting all end-to-end objectives. The Director Revenue Cycle is responsible for ensuring revenue cycle management functions are aligned and optimized to maximize collections and minimize the time and cost to collect.
Accountable for defining and tracking A/R objectives and measures, develops, and maintaining project plans, including implementation of any IT solutions and integrated platforms.
Responsible for being the liaison and consultant for outsourced vendor management, performance, and compliance. Serve as the point person for all internal Clinical Revenue Office activities. Both organizations which manage various aspects of the revenue cycle, A/R management, bank reconciliation, and customer service.
Track and audit performance of vendors and ensure service level agreements are met so that key operating metrics are achieved through outsourced activities.
Design and implement processes for billing, third party payer relationships, and collections to ensure that revenue cycle is effectively carried out.
Develop and implement strategies to accelerate and improve cash flow and manage the overall health of the receivables.
Resolve complex A/R issues and interface with revenue cycle stakeholders.
Evaluate workflow inventory in work queues for prioritizing work activities. Evaluate workflow effectiveness and performance. Evaluate trends for early intervention to achieve optimum efficiency. Makes policy and/or process recommendations as needed.
Assess and plan for adequate staffing to handle inflow of work.
Conducts periodic evaluation of workflows, identifies issues and recommend strategies for corrective measures and leads implementation. Seek to be pro-active with process improvement and other measures. Ensures that staff is engaged and trained to adopt changes as appropriate.
Reporting and Analytics
Develop and standardize reports and track metrics related to the revenue cycle performance. Perform extensive evaluate of the revenue cycle performance using multiple indicators of through metrics, trends, ad hoc reports, and A/R projects, including volume, charges, RVUs, revenue, payor mix, accrual analysis.
Monitor effectiveness of collection efforts to maintains integrity of revenue cycle within the established time frames and benchmarks to meet established targets.
Keep apprised of industry trends and identify contracting solutions based on numerous factors including changes in coding or procedures.
Implement revenue analytic tools to measure activities against benchmarks.
Provide leadership and direction for day-to-day operations within revenue cycle management to ensure all services are billed, adjudicated, and collected accurately and efficiently.
Provide recommendations to improve overall collections. Enhance and standardize workflows to achieve consistency throughout the operations.
Implement best practices to manage operations, reduce rejections, denials, and improve collection of delinquent accounts.
Assist in establishing revenue budgets, analyzing trends and implement corrective actions.
Develop and implement department specific policies and procedures. Ensure proper end-user training on all policies and procedures and interfaced modules.
Supervise key department personnel responsible for managed care credentialing, patient refunds, edits, write-offs, and bank reconciliation. Ensure efficient processes for timely resolution.
Responsible for staffing decisions of direct reports and key positions within the department. Lead and manage staff performance and facilitate appropriate feedback and reviews.
Supervise the managed care enrollment process in collaboration with internal resources.
Partner with FPO to ensure for performance of business units to achieve productivity and quality metrics. Assess quality metrics and implement remediation measures to achieve compliance and best outcomes.
Collaborate with key stakeholders for the coordination and alignment of objectives across multiple functional areas for workflow and process improvement.
Conduct various meetings to implement policies and disseminate pertinent information.
Represent the department on University wide committees pertaining to revenue cycle, credentialing and managed care contracting and keep department management appraised of institution initiatives and industry activities.
Exhibits subject matter expertise and services as a resource for the EMR implementation and optimization.
Keeps apprised of rules and regulations affecting revenue cycle. Stays current through appropriate journals and personal contacts of such developments in the industry. Learns best industry practices, conducts environmental scan and identifies potential gaps in current processes to develop proposals for senior leadership.
Serves as a patient advocate to facilitate and adjudicate patient accounts.
Carries out duties in compliance with all federal and managed care and clinical research billing guidelines.
Prioritizes requests and implements timely escalation to the appropriate teams for resolution and corrective actions.
Perform other special projects and duties as needed or assigned.
Bachelorâ€™s degree or equivalent in education and experience, plus 5 years of related experience in revenue cycle management role with progressive responsibilities.
Possess thorough understanding of hospital and ambulatory revenue cycle functions and related information systems. Comprehensive knowledge of medical coding, compliance, and third-party and government payor policies and procedures.
Possesses extensive experience with A/R management and strong data analytical skills.
Proficient in Microsoft Office, Epic, and COGNOS reporting.
Ability to build a network of contacts and interact effectively with people at varying organizational levels. Ability to effectively communicate with cross-functional leadership.
Outstanding organizational and time management skills. Highly collaborative with strong communication, writing, and interpersonal skills. Demonstrates strategic and innovative thinking.
Masterâ€™s degree in business, healthcare administration, or other related field.
Prior experience with radiology and interventional radiology billing
Leadership and project management experience in a large academic medical center.
Equal Opportunity Employer / Disability / Veteran
Columbia University is committed to the hiring of qualified local residents.
Internal Number: 513721
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