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Assistant Vice President Revenue Cycle

Company: WellStar Health System
Location: Marietta
Posted on: September 16, 2020

Job Description:

OverviewAt WellStar, we all share common goals. That's what makes us so successful - and such an integral part of our communities. We want the same things, for our organization, for our patients, and for our colleagues. As the most integrated health-care provider in Georgia, this means we pride ourselves on investing in the communities that we serve. We continue to provide innovative care models, focused on improving quality and access to health-care.Responsibilities

  • The Assistant Vice President of Revenue Cycle Operations is responsible for overseeing the DRCOs and manager responsible for accounts receivable and revenue cycle operations at all the hospitals within the WellStar Health System. The AVP of Revenue cycle operations has the responsibility of leading and providing direction to the Manager and DRCOs over seven main areas responsibilities: team leadership, revenue cycle operation duties as assigned, financial, reimbursement, denials & adjustments, resource for hospital leadership where necessary and operational and reporting responsibilities when assigned. The following is a comprehensive but not exhaustive list of responsibilities. Along with the each of these responsibilities is outlined below, other duties may be assigned as needed based on operational and business needs:

    Work with DRCO and/or Manager at each of the facility to complete the month-end close process including, but not limited, to the following:

    • Assist in the preparation and facilitation of reserves for accurate statement of monthly net revenue.
    • Ensure proper account adjudication in preparation for month end close.
    • Collaborates with the Controller to explain net revenue variances for the month end.
    • Prepare list of accounts for Working DRGs needed for month end and forward to HIM coding.

      Team Leadership duties:

      • Completes annual performance reviews for direct report employees.
      • Monitors and adjusts employee time in Kronos when needed.
      • Conduct revenue cycle meetings as needed and follow up with other Revenue cycle leadership regarding deliverables.

      • Provides for management, development, and recruitment of personnel for Revenue Cycle Services.

      • Holds monthly staff meetings.
      • Completes annual performance evaluations for employees supervised.
      • Demonstrate effective departmental leadership and provide appropriate direction to the staff
      • Apply appropriate supervisory, management and leadership techniques in an operational setting

        Regular Operational and Reporting Duties:

        • Works with staff to asses, review and approve daily work-queues, which include the following: Revenue reclass, Charity approval, Adjustments approvals, Refund approvals, Denial adjustments, Escalate adjustments, charity requests, and refunds
        • Provide oversight and direction of the daily report requests. Reports are as follows: CFB, Denials, ATB, and other reports as needed

        • System revenue cycle contact for Case Management.

          • Assist in facilitation of Patient Access requests as it relates to revenue cycle.
          • Liaison and point of escalation for revenue cycle customer service requests and issues.
          • Interface with other Revenue Cycle areas as needed regarding the following key metrics:

            • Total cash collections
            • POS cash
            • Denial write offs
            • Medicaid outliers
            • Payor trends
            • Specific accounts reviews
            • Special account handling that may be needed.

              • Assists various business units within Revenue cycle with general facility-based inquiries thus improving claims quality and overall cash performance.
              • Works leadership team in conjunction with other facility departments to resolve various revenue cycle issues, (order clarification, patient status changes, etc.).
              • Consistently communicate with vendors and their staffs to ensure ongoing issues are resolved in a timely manner.

              • Financial responsibilities

                • Monitors pass thru invoice retrieval for account billing.
                • Collaborates leadership and Controller to prepare monthly Regency LTCH invoice at specific facilities. Monitors accounts to ensure payments/adjustments are posted (Vendors billing/follow up).
                • Review, code, and approve applicable department expense invoices.
                • Facilitates and approves departmental supply order.

                  Reimbursement responsibilities

                  • Leads team in monitoring managed care contracts relating to expected reimbursement versus actual reimbursement as needed.

                  • Provides reimbursement and FMV analyses as requested.

                    Denials & Adjustments

                    • Analyze, report, and facilitate monthly meetings related to payor denial trends including the following:

                      • Monthly trends
                      • Focus (facility) denial review and process improvement initiatives
                      • Fatal Denial write off analysis

                        Hospital Leadership Activities:

                        • Participant in the following facility meetings:

                          • Revenue Cycle Operations
                          • Denial/Disputes
                          • Utilization Management (present denials and disputes)

                            • Promotes and contributes positively to interdepartmental relationships.
                            • Provide positive leadership for the department that promotes an environment of cooperation and learning.
                            • Maintain effective communication with other Patient Financial Services and Revenue Cycle departments
                            • Evaluate best practices suggestions for possible implementation into the revenue cycle processes.

                              The AVP of Revenue Cycle operations may perform complex data analysis and make independent decisions within the scope of responsibility through a shared vision driven by the Vice President of Revenue Cycle and other senior leadership. The AVP interacts with executives, directors, and all members of the Revenue Cycle within WellStar Health System, including leaders of health information management, corporate compliance, accounting and medical group revenue cycle. External contacts may consist of patients and their families, insurance companies, , state and federal agencies, auditors, and vendors. This position reports to the Vice President of the Revenue Cycle.

                              QualificationsRequired Minimum Education:

                              • Bachelors degree required. BA in Business, Accounting, Finance or related field or/equivalent broad proven practical experience in hospital billing.
                              • Masters Degree in Health Care Administration, Nursing, or Business Administration or equivalent required.

                                Required Minimum Experience:

                                • Ten (10) years hospital and physician accounts receivables experience preferred
                                • Minimum 7 years of progressive leadership including director level responsibility in a complex health-care organization.
                                • Exceptional business acumen including experience in contracting or group purchasing required.
                                • Exceptional interpersonal skills for written, verbal, presentation, and computer communication required.
                                • Experience with leading integration or other large transformation projects is preferred.

                                  Required Minimum Skills:

                                  • Knowledge of state and federal regulations as they pertain to billing processes and procedures.
                                  • Knowledge of insurance claim processing and third party reimbursement.
                                  • Knowledge and detailed understanding of all negotiated agreements.
                                  • Knowledge of the principles of Information Systems in order to effectively analyze and make decisions.
                                  • Skill in good oral, written, and interpersonal communication.
                                  • Skill in problem solving in a variety of settings.
                                  • Skill in technical or professional accounting.
                                  • Skill in time management and project management.
                                  • Ability to work efficiently under pressure.
                                  • Ability to operate a computer and related applications. Advanced proficiency in Microsoft Excel.

Keywords: WellStar Health System, Marietta , Assistant Vice President Revenue Cycle, Executive , Marietta, Georgia

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