Overview:
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HSS is consistently among the top-ranked hospitals for orthopedics and rheumatology by U.S. News & World Report. As a recipient of the Magnet Award for Nursing Excellence, HSS was the first hospital in New York City to receive the distinguished designation. Whether you are early in your career or an expert in your field, you will find HSS an innovative, supportive and inclusive environment.
Working with colleagues who love what they do and are deeply committed to our Mission, you too can be part of our transformation across the enterprise.
Director
Provider Relations
Full-Time
Overview:
The Director of Provider Relations will serve as the face of the Professional Central Billing Office for providers and their office management teams. This individual will be responsible for building and maintaining collaborative and productive relationships within the organization, while ensuring provider satisfaction and engagement and maximizing reimbursement. This will be an integral role within the Revenue Cycle accountable for evolving ongoing partnerships and proactive communication between providers and the Professional Central Billing Office. This position would be recognized as Director-level role in scope and the individual would be a key member of the internal Professional Central Billing Office leadership team.
Duties and Responsibilities (% of Time Spent)
Leadership (40%)
- Serve as the escalation point of contact, supporting the Provider Billing Partners, for providers and their office management teams, ensuring high levels of satisfaction, engagement, and trust
- Develop and implement strategies to strengthen existing relationships and establish new connections with providers and their office management teams
- Establish oneself as the lead on all Professional Central Billing Office Provider Relations initiatives
- Develop and continue to grow Provider Relations team ensuring service level being provided to PCBO providers is maintained and continuously improved
- Drive comprehensive trend research and resolution for provider specific trends identified by Provider Billings Partners and Provider Relations Analytics
- Provide timely feedback to Provider Billing Partners and encourage independent thinking
- Follow up on routine daily, weekly, and monthly responsibilities of Provider Billings Partners including assistance with identifying larger trends in denials or receivables and escalate emerging issues to VP, Revenue Cycle and Director, Patient Accounting
- Hold Provider Billings Partners accountable for meeting and exceeding quality standards and goals through recurring quality audits / evaluations
- Manage relationship with Patient Accounting team, coordinating meetings to troubleshoot issues, and ensuring policies and procedures are being followed to maximize collections
Communication (40%)
- Develop and cultivate collaborative and productive working relationships with Front Office Managers and Providers
- Partner with providers and front office leadership routinely to share operational updates, present metrics that monitor revenue cycle performance and identify strategic improvement opportunities
- Interact with stakeholders across the organization, including Patient Access, Information Technology (IT), Health Information Management (HIM), Physician Hospital Organization (PHO), Physician Services, Hospital Service Lines, and Physician Billing
- Serve as an advisor to support department-specific or system-wide improvement efforts to increase revenue capture and decrease revenue leakage across the revenue cycle
- Participate in key revenue cycle communication forums to better understand trends and advise on action plans, including metric meetings and leadership huddles
- Relay feedback to Revenue Cycle Support team including opportunities to optimize dashboards and reporting through automation and inclusion of new, more impactful metrics
Data Analytics (15%)
- Summarize key revenue cycle metrics for providers, including open encounters, charge lag, revenue, billed charges, cash collections, initial denials, avoidable write-offs, and aged receivables, etc.
- Pull, organize, and analyze data out of Epic to supplement existing dashboards to help identify performance improvement opportunities in support of maximizing reimbursement across providers
- Continuously work to identify opportunities to optimize provider dashboards, reporting, and overall resources
- Perform ad hoc analyses to identify opportunity areas within each providers revenue cycle operation and across revenue cycle operations
- Leverage analytics and identified trends to provide insights and process improvements to providers and key stakeholders
Training (5%)
- Identify training opportunities for front office staff or providers through metric research
- Escalate training opportunities to appropriate stakeholders as needed, if outside of core responsibilities (e.g., provider education)
Qualifications: Education Requirement
Bachelors Degree from an accredited university is required, Masters Degree highly desirable.
Experience Requirement
Minimum of 8 years experience in ambulatory practice management, revenue cycle management, or healthcare consulting. Experience with professional billing for surgical providers strongly preferred. Familiarity with insurance payor behaviors and reimbursement policies are required.
Skills Requirement
- Strong financial acumen within professional billing
- Ability to develop, organize, and present analytical data and statistical reports in various formats including key takeaways using data to support next steps
- Excellent verbal and written communication skills and exhibit outstanding listening capability
- Ability to inspire confidence in executive leadership, providers, and front office leaders
- Ability to synthesize information to see the big picture while effectively managing smaller details
- Strong knowledge of Microsoft Excel including, but not limited to, PivotTables, Macros, Conditional Formatting, Advanced Formulas
- Willingness, ability, and eagerness to train and mentor team
- Capability of distilling complex billing situations into actionable follow-up
- Proven knowledge and experience in understanding healthcare industry technology, regulatory laws, and regulations
- Subject matter expertise in the following healthcare functions: scheduling, registration, authorization/referral management, charge entry, coding, billing, credentialing, reimbursement, and information systems
- Demonstrated ability to work productively, independently, and collaboratively in a team environment requiring quick turnaround and quality output while juggling multiple competing priorities
- Team leadership experience including building talent, training, supervising, coaching/mentoring, and performance management
- Ability to understand, use, and manage your own emotions in positive ways to relieve stress, communicate effectively, empathize with others, overcome challenges, and defuse conflict
- Unquestionable personal integrity that exudes professional credibility and motivation
- Epic Professional Billing modules and reporting (Hyperspace, Cubes, Caboodle, Tableau) experience preferred
Other Requirements: #LI-TA1 #LI -Onsite Pay Range - Minimum: USD $160,000.00/Yr. Pay Range - Maximum: USD $190,000.00/Yr.