Director, Hospital Billing - Houston - Memorial Hermann Health System

Description

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.

Job Summary

Position is responsible for the leadership, development, vision, and operational fiscal management of the Revenue cycle for all the acute care inpatient, post-acute care, and outpatient facilities in the healthcare system. This individual will oversee all administrative and technical aspects of Operations, and design and implement effective systems, processes, and procedures to ensure accurate and timely management of Accounts Receivable which include billing, collections, denials, underpaid, cash management, credit balances and vendor management. Individual is responsible for establishing productivity and quality standards for the department, and is accountable for creating a culture of compliance, adherence to coding clinic guidelines, governmental and payer regulations, ethics, integrity and performance across the multi-facility healthcare system. This position reports to a Revenue Cycle Management executive.

Job Description

Desired Skills Sets:

• Must have extensive hospital billing experience; with at least 5yrs in a billing leadership position

• Must have experience working for a medium - large hospital system

• Experience in specialty billing

• Understands CMS rules

• Understands UB04 on the hospital side

• Experience with Form 1500

Minimum Qualifications

Education:  Bachelor's degree in Business or related field preferred

Licenses/Certifications:  (None)

Experience / Knowledge / Skills:  

• Requires ten (10) years of hospital/healthcare business office or financial management experience with a minimum of five (5) years in a supervisory role.

• Requires demonstrated pattern of growth and ability to lead, motivate, develop, and mentor others.

• Requires proven analytical ability and organizational skills necessary to organize/assess information and evaluate recommendations based on data analysis.

• Must demonstrate excellent verbal and written communication skills to support interaction and participation in meetings with physicians, payer representatives, and representatives of other departments within the organization.

• Expertise in Regulatory Guidelines with CMS, DHS, FDCPA, EMTALA, and NCCI Coding Guidelines to ensure compliant billing and collection follow-up.

Principal Accountabilities

• Provides strategic guidance and direction for system-wide financial services; create and manage a strong financial services culture.

• Leads large teams in areas of Revenue Cycle Services including Billing, Collections, Denials, Underpaid, Correspondence, Cash Management, Vendor Management, and Customer Service. Oversight includes up to 17 Acute Care Facilities, 163 Outpatient Facilities, or 300+ physicians. Service lines include, inpatient and outpatient, emergency services, life flight, trauma, transplant, outpatient imaging, laboratory, inpatient/outpatient rehab, skilled nursing, and chemical dependency.

• Develops a short and long term plan for operation that is compatible with department and organizational goals. Contribute to initiatives with Net Revenue Improvement while maintaining oversight of an accounts receivable in excess of $2.6 Billion, Annual Cash Collections $4.3 Billion, and Annual Billed Claims volume 2 Billion.

• Analyzes and establishes strategic plans to ensure the financial services are progressive and effective; work with other hospital and system service departments to promote consistency in processes; stay up-to-date on all regulatory requirements.

• Provides leadership to revenue cycle management team regarding monthly trending analysis of operational performance including weekly and monthly financial reports.

• Change Management Experience for leading staff through change. Knowledge and experience in building team effectiveness.

• Oversight of 35 to 55 staff members including all human resource related activities such as hiring and performance management.

• Ability to create performance measures, goals, and produce sustainable outcomes.

• Uses analytical approach to problem solving using quantified data and measurable results to reach sound conclusions.

• Assures that revenue, expenses, contribution margin and FTE's meet or exceed budget; prepares and submits budget and related reports; forecasts and accurately projects expenses; takes corrective action to address negative variances.

• Provides leadership and support to team members' interactions with multidisciplinary groups, including Revenue Integrity, Clinical Documentation Improvement, Case Management and Quality departments, Physicians, and other multidisciplinary groups.

• Effectively communicates with all levels of management and staff, and actively participates in committees, project teams, and performance management initiatives. Works collaboratively with all departments to ensure operational functions are aligned with strategic goals. Identify key stake holders of the organization.

• Maintains a supportive and positive working relationship with medical staff and senior level management; serves as an internal consultant throughout the organization on revenue cycle operation including reimbursement and regulatory guidelines for compliant billing and collections.

• Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.

• Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.

• Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann's service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.

• Other duties as assigned