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Employment Type:
Full time
Job Category:
Health Care Provider
Health Care & Medicine
Revenue Cycle Director
(This job is no longer available)
UCLA Health | Venice, CA
Grad Date

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Job Description

Job Duties
Under direction of the Chief Financial Officer, the Revenue Cycle Director will oversee the revenue cycle for a fast-paced Community Health Center. Responsibilities include managing and organizing the clinic's billing office operations and coding staff; monitoring daily coding volumes, productivity, turnaround times and other key indicators; creating and recommending action plans and responses to improve revenue cycle operations. This role requires current, in-depth knowledge of governmental and commercial insurance rules and regulations, including Medi-Cal, Medicare and FPACT. Regularly review all key components of revenue cycle process through dashboards, reports, queries, and other tools. Monitor timely and accurate billing, coding, collections and follow up through reporting metrics and other analytical tools. Assure coding quality and compliance with coding guidelines and reimbursement requirements. Interface with key revenue cycle stakeholders including clinical and operational leadership to identify workflow issues and barriers to an effective revenue cycle process; and recommend and helps implement solutions. Work with information technology resources and operational leadership to identify E.H.R.-related workflow issues that impact the effectiveness of revenue cycle processes; identify and help to implement solutions. Review and monitor all revenue cycle interfaces to identify workflow issues and barriers to an effective revenue cycle process for provider billing. Recommend and helps implement solutions. Lead and/or participate in other revenue cycle projects as assigned. Review and maintain familiarity with payer contracts for the clinic. Review policies and procedures periodically, at least annually, and make recommendations to the CFO. Maintain a working relationship with all department heads and assist them in developing and using financial data as appropriate. Oversee the preparation of the billing statements for submission to Medicaid, Medicare and third party payers. Analyze accounts receivables performance and resolve issues. Communicate with fiscal intermediary concerning rates, rate changes, settlement payments, recoupments, recoveries. Oversee the verification of remittance advices, for the accuracy of each report. Prepare financial and statistical reports as directed. Follow and stay updated on all compliance issues by CMS and Medicaid that will affect billing regulations. Work with other departments to analyze and recommend change regarding issues related to non-payment of claims or payer denials identified in the electronic billing system. Work closely with the Site Managers, COO, CFO, CIO, Medical Director, Director of Clinical Service, Nursing Supervisor, Pharmacy Director, IT Senior Specialist, Grants Specialist, and Insurance Enrollment Manager to ensure effective workflow as it related to the billing, compliance and revenue generating process. Responsible for credit balance review and resolution. Ensure correct and timely delivery of reports and metrics to CFO and Management. Work with Providers and Operational Directors, on issues regarding Billing. Collaborate with outside vendors on resolving system questions and problems. Evaluate the training needs of the Billing team and plan, develop and conduct training programs as needed. Participate in audits, including preparation and review of requested audit schedules, reports and documentation. Attend and participate in Coordinating Team/Large Management meetings, offering suggestions related to operational improvement, scheduling, coding, HIPAA and compliance issues. Other duties as assigned within Venice Family Clinic.

Job Qualifications
Bachelor's degree in Business Administration, Finance, Accounting, Health Care Administration, or equivalent experience. 10+ years of healthcare revenue cycle and supervisory experience. FQHC experience. Professional Coder Certification preferred. Extensive knowledge of the healthcare professional revenue cycle environment and a strong understanding of medical billing principles. Must have strong knowledge and experience in AR Management. Experience in revenue cycle system implementation, configuration, assessment and EMR. Knowledge of NextGen and medical records information system. Current knowledge of Medicare/ Medi-Cal/ Medicaid billing requirements and guidelines. Proficiency using a PC and various software applications (i.e. Word, Excel, Microsoft and Outlook). Knowledge of medical terminology, CPT (Current Procedural Terminology) and ICD10. Ability to establish and maintain effective working relationships with administrators, physicians, and peers. Ability to develop and implement strategies for efficient workflow. Ability to develop, analyze, implement, and monitor productivity levels and quality improvement strategies. Work experience in handling cash, checks, and donations. Excellent communications skills, verbal and written. Knowledgeable of accounting principles related to revenue cycle and to laws, regulations and guidelines pertaining to health care administration. Ability to seek out new methods and principles and be willing to incorporate them into existing business and accounting practices. Must possess strong analytical; time management; organizational; problem solving and decision making skills.

About UCLA Health

For more than half a century, UCLA Health  has provided the best in healthcare and the latest in medical technology to thepeople of Los Angeles and throughout the world. Today we are one of the most comprehensive and advanced healthcare systems in existence. We are comprised of Ronald Reagan UCLA Medical Center, UCLA Medical Center, Santa Monica, Resnick Neuropsychiatric Hospital at UCLA, Mattel Children’s Hospital UCLA, and the UCLA Medical Group, with offices throughout the region.

Ronald Reagan UCLA Medical Center is consistently ranked by U.S.News & World Report as one of the top five hospitals in the nation and the best medical center in the western United States. The doctors, scientists and caregivers of UCLA are leaders in their fields. Every day, they perform pioneering work across an astounding range of disciplines, from organ transplantation and cardiac surgery to neurosurgery and cancer treatment. Year after year, our people have achieved medical breakthroughs and earned the highest industry honors. And we’re just getting started.

The dedicated professionals of UCLA Health are committed to healing humankind, one patient at a time, by improving health, alleviating suffering, and delivering acts of kindness on a daily basis.