Interested in a career with both meaning and growth? Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland works together to fulfill our mission: the health and well-being of individuals and communities entrusted to our care. By joining Parkland, you become part of a diverse healthcare legacy that’s served our community for more than 125 years. Put your skills to work with us, seek opportunities to learn and join a talented team where patient care is more than a job. It’s our passion.

 

PRIMARY PURPOSE

This position plans, directs, and monitors the structure and operation of at least (1) facet of the revenue cycle division at Parkland Health & Hospital System, PHHS.  This position will have the flexibility to maneuver to all areas of the division as required for operational needs and success. The incumbent will work collaboratively with the revenue cycle division and all customers to enhance the employee and customer engagement.  Incumbent is expected to set the example for all team members by exemplifying leading from the front behaviors working alongside all staff levels and having the ability to perform the same work at the same quality, quantity, and speed.  As a supporting team member of the operations leadership team, he/she is responsible for achieving highest practice results contributing to the strategic goals of the Health System.

 

MINIMUM SPECIFICATIONS

 

Education:

- Undergraduate Degree Required

- Master's Degree preferred

 

Experience

- Minimum nine (9) years work experience in revenue cycle within a healthcare system, or related organization to include a minimum of five (5) years of management experience

- Minimum of five (5) years work experience in Denials Management and Accounts Receivable Management

- Good working knowledge of CPT, HCPCS, modifiers and Diagnosis coding, required

 

Equivalent Education and/or Experience:

- May have an equivalent combination of education and/or experience in lieu of experience as stated above.

 

Skills or Special Abilities

- Must demonstrate thorough knowledge of health care management, registration, billing and collection process for a solid revenue cycle

- Possesses the skills related to Denials Management, including but not limited to: payor authorizations/pre-certification and medical necessity justification

- Must have demonstrated skills to effectively manage denials tracking, monitoring, trending and overturning denials to improve revenue cycle performance for both institutional and professional claims

- Understanding of payer policies, procedures, NCD's and LCD.s.

- Audits, monitors and trends denials and recoveries identifying performance and areas of opportunity including system, chargemaster, coding and manual input

- Collaborate with key stakeholders identifying denial trends and process improvement opportunities, developing and applying process improvement methodologies in evaluating and improving appeal outcomes

- Demonstrates ability to communicate with all levels of Hospital personnel and external clients

- Demonstrates effective listening skills when working with individuals and/or group settings

- Seeks opportunities to initiate and build relationship the team members and customers

- Demonstrates leadership skills that influence others, fosters teamwork, creates a motivating environment, and coaches and develops staff

- Must have excellent organizational skills with the ability to manage staff and projects in a fast paced environment

- Demonstrates the ability to identify and articulate problems and suggest possible solutions

- Possesses excellent tactical execution skills, proficiency in prioritizing and managing multiple tasks

- Partner with enterprise operations leaders, recommend and implement changes to processes, tools and/or methodology to ensure continuous improvement in operational efficiency and quality of services being delivered while achieving operational budgets.

 

Responsibilities

1. Provides direct management of Customer Service, Denials, Accounts Receivable Management, Payment Processing and Vendor Managment areas of the revenue cycle as directed or needed.

2. This position is responsible for the supervision of full-time employees in a unit or department. This position has the responsibility to evaluate performance, hire, terminate, and perform any counseling or disciplinary actions that are required.

3. Demonstrates initiative in taking on tasks and volunteers to lead project specific endeavors.

4. Analyzes problems/issues to identify root cause.

5. Identifies performance gaps and effectively lead changes to address. Recognizes and capitalizes on opportunities for sharing knowledge and information with others.

6. Provides a healthy team environment providing team support, commitment and accountability for achieving results. Assists team in setting and/or reaching objectives and in managing time constraints/deadlines.

7. Interfaces with external entities such as third party payers, regulatory agencies, and other health care institutions, vendors, patients and families.

8. Assists in developing divisional operating and capital budgets and ensures that budgets are maintained and ensures proper utilization of organization¿s financial resources.

9. Provides organizational direction and monitoring to ensure compliance with government regulations, HIPAA standards, and payer billing requirements.

10. Review and recommend modification of patient access, billing, collections and revenue integrity policy and procedures as well as fee schedule and charge mechanisms to ensure compliant claims to maximize reimbursement by third party payers and to encourage payment by patients.

11. Actively involved in establishing revenue cycle key performance indicator goals and collaborates with staff and external departments to achieve those.

12. Invest in development of management and staff by encouraging and modeling behavioral expectations on a daily basis while continuing to keep Diversity and Inclusion at the forefront. Provides a satisfying and enriching environment in which staff can be developed and retained

13. Demonstrates respect and regard for the dignity of all patients, families, visitors and fellow employees to ensure a professional, responsible and courteous environment.

14. Performs other duties or responsibilities as assigned.

 

Job Accountabilities

1.  Identifies and analyzes the design of jobs, work processes, work flows, etc. for the area and implements appropriate changes to improve effectiveness, productivity, and efficiency that support the overall goals of the department and Parkland.
2.  Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrates knowledge gained into current work practices.
3.  Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans. Seeks advice and guidance as needed to ensure proper understanding.
4.  Develops and monitors annual budgets that ensure the department has the necessary funds to carry out the goals and objectives that have been established for the department.
5.  Develops, implements, monitors, and revises annual goals and objectives for the department that support the missions and objectives of Parkland.
6.  Selects, trains, schedules, motivates, supervises, and evaluates employees making recommendations for disciplinary actions up to and including termination, to ensure maximum utilization of individual and group capabilities. Ensures that assigned employees receive opportunities to further their knowledge.

 

Parkland Health and Hospital System prohibits discrimination based on age (40 or over), race, color, religion, sex (including pregnancy), sexual orientation, gender identity, gender expression, genetic information, disability, national origin, marital status, political belief, or veteran status. As part of our commitment to our patients and employees’ wellness, Parkland Health is a tobacco and smoke-free campus.