The Director of Revenue Cycle provides leadership to the ongoing development, implementation and oversight of operations across the Revenue Cycle that Cook Children's Health Care System (CCHCS) serves.Leads the operational implementation and continued daily functions of Epic Revenue Cycle for Cook Children's Medical Center and Cook Children's Physician Network, with a primary responsibility for revenue integrity activities across denials and will be a resource to provide support and guidance by working closely with other departments on the following areas; charge and payment reconciliation, claims, coding, collections, reporting, RAC/government audits, internal revenue cycle audits, charge description master, utilization review, physician and nursing education. Accountable for the planning and successful transition of Revenue Cycle systems, organizational and operational development of staff within the applicable patient accounting applications. Partners with Patient Accounting, Patient Access, Compliance, Contracting, Clinical and Business Units to ensure that Revenue Cycle application and operational needs are performed efficient and cost effective while meeting the needs and goals of the organization.
Education: Bachelor's degree in nursing, healthcare or business required, Master's degree preferred.
Management: 5+ years' experience in a healthcare financial management or director level role;ability to demonstrate strong leadership within matrix teams.
Healthcare/Business: Expert knowledge of healthcare revenue cycle including; charge capture, billing, medical necessity criteria, utilization review, denials, CDM. Extensive knowledge of Patient Financial Services accounting systems and operations. Strong knowledge of ICD-10 coding, CPT coding, MS-DRG's, APC's, contracts and applicable rules and regulations affecting reimbursement for medical services. Detailed Clinical knowledge with strong physician and clinician level communication skills.
Epic: Prior experience with Epic Systems Revenue Cycle Solutions preferred.