About Our Company We're a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care. Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes and virtually through VillageMD and our operating companies Village Medical, Village Medical at Home, Summit Health, CityMD, and Starling Physicians. When you join our team, you become part of a compassionate community of people who work hard every day to make health care better for all. We are innovating value-based care and leveraging integrated applications, population insights and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care.
Job Description Job Description Reporting to the VP of Revenue Cycle and will be responsible to provide recommendations for process improvement within coding operations. Areas of oversight include manual charge capture, coding edit resolution, provider documentation and coding auditing and education. The Director will partner with leaders across the organization to develop plans that will improve the financial performance of our clients involving a high degree of analyzing and interpreting data and generating reports that present charge capture and coding improvement opportunities.
Essential Job functions: - Collaborating with Summit management in the development of performance goals and long-term operational plans
- Defining, implementing, and revising operational policies and guidelines for the organization.
- Developing and executing new growth directives.
- Provides direction and oversight of Revenue Cycle Operational Coding Services, including but not limited to, charge capture, billing, coding denials, vendor, and staff management.
- Build and maintain relationships with all department heads, external partners, and vendors to make decisions regarding operational activity and strategic goals
- 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 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
- Provides and/or supports project management of any EHR implementation/integration and other Revenue Cycle Management Initiatives
- Oversees the analysis and recording of coding adjustments, write offs and denial activity; provides reporting on trends to management along with suggestions to mitigate future write offs and denied claims
- Oversees vendor support services
- Other duties as assigned.
Physical Job Requirements: - Physical agility, which includes ability to maneuver body while in place.
- Dexterity of hands and fingers.
- Endurance (e.g., continuous typing, prolonged standing/bending, walking).
Education, Certification, Computer and Training Requirements: - Bachelor's Degree in business, Accounting or another related field required.
- Master's degree preferred.
- Minimum of five (5) years progressive experience within physician healthcare receivables management in a complex academic medical center or multi-hospital system.
- Experience with professional billing electronic health records.
- Certified Professional Coder (CPC) certification and Certified Professional Medical Auditor (CPMA)
About Our Commitment Total Rewards at VillageMD Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families. Participation in VillageMD's benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan.
Equal Opportunity Employer Our Company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws.
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