Catholic Health Initiatives Director of Revenue Integrity - Mercy Physician Billing Office in DES MOINES, Iowa
Director of Revenue Integrity - Mercy Physician Billing Office
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.
- Work includes all other miscellaneous office duties/projects as assigned.
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.
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.