Catholic Health Initiatives Director of Revenue Integrity - Mercy Physician Billing Office in DES MOINES, Iowa

Director of Revenue Integrity - Mercy Physician Billing Office

Description

GENERAL SUMMARY :

Responsible for all aspects of Iowa Division Physician Revenue Cycle ($300 million in billing) including registration, provider enrollment, insurance verification, coding, payment processing, patient accounts and collections. Assists the CFO/VP, Mercy Clinics, Inc. as it relates to payer contract negotiations. Interfaces with clinical areas and supports physicians with information and education, as directed .

ESSENTIAL FUNCTIONS :

  • Implements and maintains PPMS.

  • Participates on MPMT and EGC.

  • Serves as Physician Enterprise Revenue Cycle Chair

  • Serves as Physician Enterprise Revenue Cycle Liaison between CHI Revenue Cycle Team and Mercy Health Network (MHN).

  • Establishes and maintains processes, policy and benchmarks that maximize operational effectiveness and efficiency within department in order to achieve organizational goals.

  • Approves operating budgets for departments within PBO.

  • Represents the clinic in interactions with patients, professional organizations, government agencies, elected officials, regulatory bodies and payers.

  • Develops and maintains effective relationships with all areas of the organization specifically Administration, Patient Care, Accounting and Information Services.

  • Serves on the Compliance Committee and supports the organization's compliance plan and activities.

  • Resolves billing complaints.

  • Keeps abreast of all reimbursement billing procedures of third party and private insurance payers and government regulations.

  • Assists with strategic planning activities.

  • Provides leadership and is responsible for the overall direction, coordination and evaluation of PBO for Mercy Clinics, Iowa Heart, Skiff and Centerville.

  • Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws.

  • Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

MARGINAL FUNCTIONS:

  • Work includes all other miscellaneous office duties/projects as assigned.

Qualifications

MINIMUM KNOWLEDGE, SKILLS AND ABILITIES REQUIRED :

  • Bachelor's degree from four year college or university or minimum of seven years’ related experience and/or training; or equivalent combination of education and experience required.

  • Master’s degree preferred

  • Thorough knowledge of third party billing requirements and Medicare regulations.

  • Knowledge of compliance requirements within the health care industry.

  • Knowledge of electronic billing systems preferred.

Job Director/Manager/Supervisor

Primary Location IOWA-DES MOINES-MERCY MEDICAL CENTER

Daily Schedule Days

Scheduled Hours per 2-week Pay Period 80

Weekends Required None

Req ID: 2018-R0166207

We’re an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.