University of Rochester Director, Professional Revenue Cycle in Rochester, New York
Full Time 40 hours Grade 057 URMFG Administration
8 AM-5 PM
Directs and manages activities that affect professional fee revenue cycle operations for the University Medical Faculty Group (URMFG), from point of entry to accurate adjudication of patient accounts, in accordance with URMFG policies and standards as well as applicable regulatory requirements. This scope is to include, but not be limited to, billing and collections, patient insurance, data processing, cash management, integrity of patient accounts, customer service, and accounts receivable.
The incumbent ensures the quality of billing systems and processes to provide for maximum reimbursement and cash flow, and to ensure the provision of timely and effective customer service. Work also includes managing the central business office budget and resources in accordance with organizational priorities.
Under general direction and with latitude for independent judgment:
Manages professional receivables by observing trends, identifying problem areas and directing actions to resolve any deficiencies. Develops, recommends and implements financial policies and procedures relating to receivables. Evaluates impact on receivables caused by the activities of other departments and acts as a liaison between MFG Business Office staff and other Professional departments, third party agencies, insurance companies and patients to conduct activities and solve problems.
Possesses a knowledge of third party billing and reimbursement procedures, reviews and updates procedures to assure third party collection activities. Monitors existing vendor relationships and suggests any necessary changes to vendors utilized in support of the revenue cycle for the URMFG revenue cycle team.
Coordinates facility charge activities with MFG Business Office staff to ensure that correct accounting entries are made and that ongoing communication is occurring; ensures that policies and procedures maximize the URMFG’s financial position.
Monitors quality assurance to track accuracy and timelines of posting, billing and collection activities to ensure that established standards are met. Develops, recommends and implements policies and procedures for the assigned units so that an appropriate billing and payment cycle for accounts is maintained. This scope is to include, but not be limited to, billing and collections, data processing, cash management, integrity of patient accounts, insurance verification and authorization processes, customer service, and accounts receivable. Ensures that internal controls are in place to safeguard accounts receivable records and the collection and application of cash. Coordinates education, priority setting and action plans with the Chief Financial Officer, MFG. Coordinates responses to audits with Legal and Compliance in accordance with deadlines ensuring that all relevant information is provided to auditors.
Accountable for Billing Office Revenue Cycle Managers across MFG enterprise. Establishes and maintains a positive working relationship with billing administration of other professional departments, to advise them of professional billing and collection policies and procedures. Presents in-house training sessions; makes recommendations on policies of other departments that affect professional receivables. Serves on several internal teams and on committees with senior leadership. Takes the lead on billing related projects as needed that affect several URMC entities. Assures appropriate activities are performed to successfully complete assigned professional projects.
Designs and prepares periodic reports and dashboards for areas of responsibilities. Prepares and monitors operating budget and wage and salary programs for department. Maintains inventory and purchasing controls; coordinates the development and submissions of capital budget requests. Authorizes large dollar refunds to patients and insurance companies and approves large dollar requests for write-offs.
Maintains an in-depth knowledge of third party payer procedures and regulations as well as a working knowledge of credit collection and financial policies. Acts as a liaison between MFG Business Office staff and management staff in the Information Systems Department to identify and prioritize projects that will support established objective and policies.
Directs, coordinates and evaluates the activities of several managers under own supervision. Assists managers and their supervisors in setting standards, assigning priorities and evaluating staffing plans. Assists managers and supervisors in monitoring and controlling the activities of their staff. Plans, directs, and evaluates the work of staff; complies with human resources management regulations; ensures adequate staffing levels; makes employment decisions, establishes performance standards, and evaluates employee performance; educates, guides, counsels, and develops staff; and addresses performance management concerns. Assures that University policies are interpreted and communicated correctly and consistently in the department. Monitors for safe working conditions and takes corrective action when necessary. Assure that ongoing communication occurs with staff via routine meetings and publications.
Develops budgetary plans, programs, and guidelines to ensure the team’s strict adherence to financial guidelines and requirements. Ensures that operating expenses are well within the prescribed limits of budget plans and fiscal guidelines.
Establishes and maintains a good working relationship with staff from private and governmental agencies as needed to solve major problems and to establish new procedures. Represents URMC by planning and participating in meetings and seminars outside of MFG at the local and state level.
Master's degree in Business Administration or equivalent graduate training and 8 years of relevant work experience including substantial work at a managerial level in a billing office; or an equivalent combination of education and experience. Prefer strong working knowledge of professional billing software applications, third party billing and reimbursement procedures, collections, revenue integrity, professional fee coding as well as Medicare and Medicaid billing requirements.
EOE Minorities/Females/Protected Veterans/Disabled
Job Title: Director, Professional Revenue Cycle
Location: Medical Faculty Group
Job ID: 207253
Full/Part Time: Full-Time