Director of Revenue Cycle Management

St. Louis, MO

We are South City Hospital. Our primary function is to offer continuous nursing, medical, and other health and social services on a 24-hour basis, under physician directed care and RN supervision.

We service a multitude of patients and their families across our vast network, while remaining committed to the professional development of our staff, the functional improvement of our patients, and the cultivation of strong partnerships within our communities. 

WHAT WE OFFER 

  • Essential/stable and growing company with many opportunities for training and advancement within the medical field that all employees and team members (including Full-Time and Part-Time) can benefit from. 
  • Hourly pay is negotiable based on experience. We offer competitive market pay and opportunities for bonus depending on great work performance (bonuses only apply for Full Time). 
  • Comprehensive Employee Benefits: Full-Time employees are eligible for various plans for medical, dental, and vision insurance.

The Director of Revenue Cycle Management reports to the CFO and is responsible for overseeing and coordinating all revenue cycle activities with a goal of maximizing reimbursement in a cost-effective manner that is in compliance with federal, state and payer-specific billing requirement.  The Director will oversee all overall policies, objectives and initiatives for South City Hospital revenue cycle activities to optimize the patient financial interaction along with the care continuum.   

PRIMARY RESPONSIBILITIES

  • Responsible for the provision of the direction and supervision of all SOUTH CITY HOSPITAL revenue cycle functions, ensuring a strategy and vision for these services that support the SOUTH CITY HOSPITAL Strategic Plan and vision.  Accountabilities include coordination and implementation of SOUTH CITY HOSPITAL managed care contracting, financial counseling, charge capture, HIM, coding, clinical documentation improvement, clinical resources management, discharge planning, social workers, RAC nurse auditors, physician advisor, patient financial services, and revenue cycle analytics. 
  • Responsible for development and updating of contractual allowance, bad debt reserve and IBNR modeling.  Working collaboratively with any physician advisors and medical staff to ensure continuous improvement for the physician documentation.  Assisting business development with contracting strategies to identify growth opportunities.   Working closely with physicians to improve patient throughput as well as clinical documentation.  Chairing the Revenue Optimization Council (ROC) to ensure billing compliance and collection effectiveness.  Partnering with the Quality department to meet the Patient Safety Indicators (PSI) and other quality metrics through coding accuracy and documentation improvement.  Participate in month-end financial close as well as annual financial audits.  Primary contact and liaison to external financial and regulatory auditors. 
  • Continuously improves knowledge, skills, and performance to achieve excellence in patient safety, quality, and service. Including, strategically planning and managing talent, mentoring, and coaching to improve organizational effectiveness, and cultivates a learning organization.
  • Plans for and makes decisions within the framework of the enterprise’s strategic intent. Anticipates future trends using information from Customer/Patients, communities, and industry. As well as identifies current and future business needs and opportunities.
  • Develops, implements, and administers revenue cycle management policies and procedures.  Practices excellent employee relations and attention to employee needs.  Develops and mentors a high performing management team for all areas of responsibility.  Ensures financial viability by managing both applicable revenue and expenses with attention to supply cost utilization and a high level of productivity in cost centers under direct control.  

EDUCATION/EXPERIENCE 

  • Bachelor's Degree in Business or related field; Master's Degree with emphasis in Business or Healthcare Management Preferred
  • 8 years financial management including 5 in revenue cycle leadership roles, general accounting, financial management/reporting
  • Certified Public Accountant preferred
  • HFMA Certified Revenue Cycle Representative Preferred
  • Thorough knowledge of patient financial services (PFS) processes and standards related to billing, collections, and cash posting. General knowledge of patient registration, finance, and data processing.
  • Knowledge of regulatory requirements related to patient accounting, including a solid understanding of Medicare, Medicaid, and managed care processes.
  • Ability to work and communicate effectively with a diverse group of people including other department managers, staff, physicians, patients, and the public
  • Ability to read, analyze and interpret financial reports, contracts, and other legal documents.
  • Outstanding ability to work independently to achieve results. Must originate, plan, adapt and invent to accomplish tasks.
  • Dedication to the development of others and willingness to coach and mentor people as necessary to promote their personal and professional growth.
  • Speaks and reads English at a level that is sufficient to satisfactorily perform the essential functions of the position.
  • Strong analytical and problem-solving skills.
  • Ability to set and maintain priorities when dealing with multiple demands and interruptions.
  • Knowledge of standard office equipment (i.e., calculator, fax, photocopier) and personal computer and computer software skills (i.e., MS Windows, Excel, Access, Word, PowerPoint, internet, e-mail). 
  • Windows computer skills including proficient use of keyboarding, use of mouse or keys for functions. 
  • Performs other duties as assigned. Follows SOUTH CITY HOSPITAL, policies, procedures, applicable laws and standards. Carries out the mission, vision, and quality commitment of SOUTH CITY HOSPITAL.