Director Revenue Analysis

Job Summary 

The position will be responsible for all aspects of the Revenue Cycle.  Provide leadership, staff development, and supervision related to Revenue Cycle. The position will work with other functional facility leaders and Facility Leadership to identify weakness in the Revenue Cycle process.  The position will also interact heavily with Conifer to address process flaws or weaknesses that are causing collection issues on the back end of the Revenue Cycle.  It is essential for this position to review points of A/R build up with Conifer, identify the cause, and help implement a solution.  The position will not be successful without close alignment with Facility Operations and Conifer in the identification of Revenue Cycle weakness. 

• Establish a multi-disciplinary team including hospital, Home Office and Conifer individuals to identify revenue cycle opportunities  
• Monitor and ensure achievement of Conifer benchmarks  
• Work closely with CFO and Conifer to continually evaluate the activities of revenue cycle, shifting strategies and tactics as necessary  
• Improve the level of quality of revenue cycle decisions that have financial implications to the organization  
• Monitor/analyze AR/disputes and work with revenue cycle team members to prevent denials  
• Implement revenue cycle operational/process best practices across Tenet and Conifer, ensuring consistency once adopted.  The areas of review will include but not limited to POS Cash, admitting, billing, authorization, reclasses, appeals, rebills  
• Examine, and analyze patterns of payment discrepancies and escalate to Managed Care or appropriate party to resolve  
• Analyze and approve single case agreements/LOAs  
• Identify changes to Policy and Procedures for discussion and implementation  
• Provides direction and ensures appropriate handling of accounts by Medicare/Medicaid liaison and NIC  
• Responsible for coordinating RAC/MAC/Payor DRG audits for timely facility response  
• Provides oversight for the DNSP process and works with revenue cycle departments and Conifer for timely billing  
• Ensure review and approval of requested adjustments, refunds and revenue re-class accounts  
• Responsible for appropriate adjudication of account balances on high $$$ accounts prior to month-end (credit and debit balance review)  
• Month-end eReserve completion and assists in month-end reporting and identifying items/trends that significantly impact net revenue as required  
• Ensures clinical research process is implemented and correctly followed. Responsible for assisting with required information and clinical research billing requirements as outlined by Tenet  
• Monitor and manage accounts on the Cash Pay report daily for timely payment  
• Monitors and manage client billing process for vendors as assigned  
• Analyzes and reviews accounts applicable to the physician discount process  
• Acts in customer service role as required for patient with billing and charge concerns and/or physician offices with a billing or charge concern coordinating with Conifer audit services

• Minimum Requirements 
  • Education: Bachelor Degree in Business, Health Administration or related degree. 
  • Experience:  Four (4)+ years in A/R management and/or managed care contracting and analysis as well as directing a multi-facility business office. 

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