Corporate Director Billing Optimization
Corporate Director Billing Optimization
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Job Description
Overview
Prime Healthcare is an awardwinning health system headquartered in Ontario California. Prime Healthcare operates 45 hospitals and has more than 300 outpatient locations in 14 states providing more than 2.6 million patient visits annually. It is one of the nations leading health systems with nearly 50000 employees and physicians. Fourteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation a 501(c)3 notforprofit public charity. Prime Healthcare is actively seeking new members to join our corporate team!
Responsibilities
The Corporate Director of Billing Optimization is responsible for the strategy management and implementation of the Enterprise Billing Program actively owning the portfolio across Revenue Cycle Management and drive optimization and improved metrics across the clearing houses. The Director will partner with revenue cycle and business office leaders across all levels of the organization to execute goals and plans of reach / exceeding key performance indicators (KPI) relating to billing operations which include but are not limited to: 837 files billing edits clean claim rate standards billing errors and trends as well as claim rejections and trends. Through strategy development aligning the annual initiatives and collaboration the Director will lead improvement efforts through of business objectives and strategic initiatives. The Director will provide issue resolution develop and implement standard operating procedures (SOP) when needed participate in golive implementations to ensure successful transition as well as provide effective communication and stakeholder management at all times. The Director is accountable to the VP of Outsourcing and Strategic Initiatives for timely reports and updates relating to key initiatives delivering successfully on timelines as well as effective management of staff and delivery of appropriate productivity and quality parameters if the Director has direct reports.
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Qualifications
EDUCATION EXPERIENCE TRAINING
Required qualifications:
- Bachelors degree (B.A.; a minimum of 810 years related experience and/or training; or equivalent combination of education and experience.
- Five 5 years of experience with acute hospital/ facility revenue cycle setting.
- Prior working experience within Supervisory/ Management capacity specifically with Billing Integrity Revenue Integrity and Billing Process includes managing the billing for all payors includes managing bridge routines.
- Prior experience in implementing clearing houses and preferably rollout of EPIC program in a large hospital setting.
- Ability to envision and execute; process and policy changes change in corporate culture alignment between enterprise strategy and individual business channel needs.
- Proven ability to effectively interact with key stakeholders hospital leadership and other team members while maintaining standard of professional business service
- Strong communication and relationship management skills.
- Ability to form collaborative working relationships.
- Strong analytical and problemsolving skills. Ability to review weekly monthly metrics leading and lagging KPIs and own action plans. Proven ability to make logical correlations between data points to determine if analysis is accurate.
- Ability to envision and execute; process and policy changes change in corporate culture alignment between enterprise strategy and individual business channel needs.
Preferred qualifications:
- Proficiency with IT hospital revenue cycle tools like CHC / Relay Assurance (also known as ePremis now part of Optum) EPIC Meditech.
- Advanced knowledge and management of bridge routine files writing and modifying CCI edits 835 EFT ERA and claim error trends across multiple payor base and across states.
- Meditech and EPIC: basic navigation of systems as a minimum.
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race color sex sexual orientation gender identity religion national origin age (subject to applicable law) disability military status genetic information or any other basis protected by applicable federal state or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: Experience:
Director
Employment Type
Full-Time
Key Skills
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