Join the Cleveland Clinic team where you will work alongside passionate caregivers and provide patient-first healthcare. You will work alongside dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world. The Senior Director of Professional Billing Operations is a new enterprise position, based in Cleveland, OH, that will develop and deploy a strategic vision that will drive the direction of Billing Operations, optimize net patient revenue and deliver a world class patient billing experience. Leads successful and compliant professional insured insurance billing, follow-up, denials management and prevention. Facilitates continuous improvement, reduced unbilled and denial cycle times and timely resolution of billing, insurance collection, and denial issues. **A caregiver who excels in this role will:** + Provides strategic direction, leads innovations and operational enhancements and standardization by leveraging best practices and technology to create best in class corporate accounts receivable insurance billing operations. + Collaborates to build and implements efficiency strategies around first pass payment rate. + Develops and executes initiatives to improve the patient billing experience, revenue realization, and operational effectiveness. + Develops a comprehensive strategy to respond to current and future challenges presented by legislation, compliance, health care reform in order to monitor and address changing revenue cycle practices. + Maintains functional accountability for the insurance claiming function, follow up, denials distribution and a significant operation of denials remediation based on type of denial. + Oversees the operation of to include; budget preparation, salary administration, equipment purchases, and establishment of annual goals and objectives. + Assists billing operations to meet corporate goals for cash collections, net revenue comparisons, and billing expense. + Ensures compliance with all federal, state, and local regulations governing rendered patient services and reimbursement. + Ensures consistent implementation of corporate financial policies for Account Receivable issues such as; insurance small balance write offs, controllable loss, agency use and contract terms. + Oversees the administrative and clinical denials management to include prevention, resolution, reduction, trends, education, and mitigation of controllable loss. + Leads billing vendor-management oversight to include monitoring and auditing performance and ensuring compliance with service level agreement(s). + Other duties as assigned. **Minimum qualifications for the ideal caregiver:** + Bachelor's degree in healthcare or business related field required. + Master's degree preferred. + A minimum of 10 years of progressive leadership and managerial experience in a large, multi-facility Hospital, Clinic or Group Practice Hospital (Physician led preferred), consulting or healthcare related industry. Five years of experience of billing or patient financial services in acute care and/or ambulatory setting(s) preferred. **Preferred qualifications for the ideal caregiver:** + At least 10 years of revenue cycle experience, particularly in hospital and professional insurance billing, denials management, patient balance management, financial reporting and analytics, and revenue cycle technology with at least 10 years in a leadership role + Team player who is approachable and collaborative with excellent customer service and employee engagement skills + Extensive knowledge of government and non-government payer requirements such as Medicare, Medicaid, Third-Party Liability, Workers' Comp, and Commercial Insurance + Knowledge of managed care contracting, charge capture, controllable loss, state and federal regulatory standards, rules and patient-focused solutions + Excellent critical thinking and oral and written skills, along with the ability to effectively communicate to a large, divers e audience and all levels of the organization + Ability to evaluate and implement technology and automation solutions and drive innovation while collaborating with diverse groups + Agility, influence, emotional intelligence and the ability to drive results + Leadership experience driving positive results in a collaborative, metric-driven and complex environment + Demonstrated experience in matrix management and ability to treat dotted lines as solid lines **Physical Requirements:** + Ability to communicate and exchange accurate information. + Ability to perform work in a stationary position for extended periods. + Ability to work with physical records or operate a computer or other office equipment. + In some locations, ability to travel throughout the hospital system. + In some locations ability to move up to 25 lbs. **Personal Protective Equipment:** + Follows standard precautions using personal protective equipment as required. Our caregivers continue to create the best outcomes for our patients across each of our facilities. Click the link and see how we're dedicated to providing what matters most to you: https://jobs.clevelandclinic.org/benefits-2/ Pay Range Minimum hourly: $72.70 Maximum hourly: $143.58 The pay range displayed on this job posting reflects the anticipated range for new hires. While the pay range is displayed as an hourly rate, Cleveland Clinic recruiters will clarify whether the compensation is hourly or salary. A successful candidate's actual compensation will be determined after taking factors into consideration such as the candidate's work history, experience, skill set, and education. This is not inclusive of the value of Cleveland Clinic's benefits package, which includes among other benefits, healthcare/dental/vision and retirement. Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities