The Vice President of Physician Revenue Cycle is responsible and accountable for the strategic planning, leadership and ongoing continuous quality and process improvement for the physician revenue cycle of RWJBarnabas Health Medical Group. This position will ensure optimal coordination of the following components: physician credentialing, charge entry, coding, billing, collections, denials management and billing compliance.
Leadership, Staff Management and Organizational Strategy
Promotes and supports a working environment consistent with the values-based culture of RWJBarnabas Health
Provides value-based supervision, support, and guidance to direct reports; identifies and creates leadership and professional development opportunities for direct reports
Leads the Revenue Cycle in planning, coordinating and executing policies, procedures and strategies within the department
Partners with Senior Leadership and other stakeholders to achieve strategic objectives through successful implementation/completion of strategic initiatives
Electronic Health Record (EHR)/Other RCM Technology
Partners with Operations and Senior Leadership to assess and implement technology to enhance revenue cycle management
Provides and/or supports project management of EHR implementation and other Revenue Cycle Management Initiatives
Ensures integrity of the EHR and related processes to minimize organizational risk
Ensures systems and processes are in place to maintain and support the use of the EHR
Revenue Cycle Management
Provides direction and oversight of Revenue Cycle Operations, including but not limited to credentialing, charge capture, billing, claim follow-up and collections, payment application, and denials management
Develop strategies across all functional departments to exceed cash collections, reduce days in AR, and reduce denial and adjustment rates
Partners with Operations and Senior Leadership around all aspects of the revenue cycle
Tracks and monitors key revenue cycle performance indicators; reports key findings to appropriate leadership and stakeholders across the organization
Ensures systems and processes are in place to ensure compliance with contract requirements around submission of claims; including service provision/documentation, established fee schedules, credentialing, and site enrollments
Partners with the Managed Care Team to manage payer contracts and support payer relationships
Provides guidance and supports provider enrollment and payer credentialing
Provides oversight, in collaboration with financial leadership, on the general ledger close as it relates to revenue, accounts receivable and billing
Ensure internal controls, policies and procedures are consistent state and federal law, compliance plans and HIPAA
Corporate Accounts Receivable Management and Reporting
Monitors and reports monthly to management; providing analysis of trends in aged balances across divisions, customers, and programs as well compared to trends in the industry
Monitors collections to established goals to maximize cash flow and to monitor claim submission to provide ongoing process assessment and resolution
Oversees the analysis and recording of revenue adjustments, write offs and denial activity; provides reporting on trends to management along with suggestions to mitigate future write offs and denied claims
Bachelor Degree in Finance, Accounting or other related field required.
Master Degree preferred.
Minimum of seven (7) years proven, progressive experience in physician healthcare receivables management in a complex academic medical center or multi-hospital system with 1000 or more physicians.
Proven experience in Physician Revenue cycle.
Familiar with Medical Terminology.
Certified Professional Coder (CPC) certification, preferred.
Experience with Electronic Health Records (EHR).
Ability to manage multiple work streams, projects, tasks and goals.
Knowledge and experience with industry charge methodology, billing and collection regulations.
Individual will be required to travel to Oceanport, Somerset, and West Orange Corporate facilities on a regular basis.