|
Inspire health. Serve with compassion. Be the difference. Job Summary Responsible for the strategic development, implementation and operation of the Corporate Revenue Cycle functions. Plays an integral role in the strategic direction, goal setting and performance management of the Revenue Cycle ensuring that the revenue cycle functions, and clinical processes are effectively and efficiently aligned for optimal communication, collaboration and coordination. Leads all aspects of the Revenue Cycle to ensure the optimal collection and customer service performance for the organization. Has as direct reports Clinical Services Business Operations, Health Information Management, Managed Care Contracting and Compliance, Patient Access and Standardization, Patient Financial Services, Reimbursement and Central Scheduling.
Essential Functions
All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Assists in development of short and long term strategic and performance goals for the Revenue Cycle Group that appropriately align with the mission, vision and values of the organization and health care billing and reimbursement best practice guidance. Provides leadership role in the establishment of employee, departmental and organizational performance benchmarks utilizing industry best practice data and trending. Develops monitoring and communication plan for the reporting of performance towards goals to ensure enterprise-wide cooperation and compliance. Develops, implements, monitors and supports process redesign and improvement efforts through ongoing review and audit of Revenue Cycle policies, procedures and performance standards. Serves as final approval for all Revenue Cycle operations procedures, policies and standards. Fosters an employee culture that supports the Revenue Cycle and Organization strategy. Establishes training and networking programs focused on enhancing employee job knowledge and ability. Provides coaching and counseling as necessary and oversee the performance evaluation process for the Revenue Cycle functions. Establishes individual performance expectations for direct reports and regularly evaluate their performance against organizational objectives. Monitor payor performance, contractual adjustment and contractual compliance issues. Participate in the Finance Committee on Contracting. Directs governmental reimbursement and regulation compliance. Ensures that all third-party cost reports and regulatory reports are prepared timely and accurately. Ensures complete, accurate and compliant patient billing and collection practices consistent with Patient Friendly Billing guidance. Oversees patient financial clearance for the enterprise including central scheduling, patient access standardization, financial counseling and benefit verification. Develops organization wide patient financial clearance standards based on industry best practice guidance. Provides training, monitoring and support to organization. Directs enterprise-wide Health Information Management standardization and compliance based on industry best practices. Develops and implements training, monitoring and support to organization Health Information Management areas. Manages the charge description masters and pricing strategy in collaboration with other internal departments to ensure complete and accurate charging capability and functions across the enterprise. Administers the charge capture audit and assessment process for all acute care facilities. Develops and achieves departmental budgets for all areas of responsibility including development of short- and long-term goals, process improvement initiatives and key performance indicators. Provides estimates of future human resource and equipment needs necessary to achieve established goals. Ensures compliance with federal, state and managed care requirements. Monitors external environment as it relates to the Revenue Cycle operations to anticipate and adapt to significant changes in the healthcare environment, best practices and trends. Performs other duties as assigned.
Supervisory/Management Responsibilities
Job has direct and/or indirect supervision of team members that may include final budget authority, hire/termination authority, performance appraisal responsibility and disciplinary authority. Job will be considered a member of management staff at Prisma Health or affiliate and will have direct reports.
Minimum Requirements
In Lieu Of
Required Certifications, Registrations, Licenses
Knowledge, Skills and Abilities
Work Shift Day (United States of America)
Location Prisma Health Corporate Office
Facility 7001 Corporate
Department 70019430 Finance - Executive
Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.
|
Prisma Health
May 23, 2025