Current Compassus Colleagues: Please apply via Workday.
The Director of Revenue Cycle is responsible for modeling the 3 Company values of Compassion, Integrity, and Excellence, and for promoting the Compassus philosophy, using the 6 Pillars of success as the foundation. S/he is responsible for upholding the Code of Ethical Conduct and for promoting positive working relationships within the company, among all departments, and all external stakeholders. The Director of Revenue Cycle is responsible for the oversight/management of Orders/Document management, including the roles of Claim Director, Claims Specialist and Medical Record Coordinators, of claims and authorization Workflow tasks and Forcura Orders tracking and management. S/he is responsible for assembling and leading a high-performing team and deploys a customer-centric approach to the Revenue Cycle components, enabling achievement in both strategic and financial goals.
Regulatory Compliance Pillar of Success
- Engages all colleagues in the Regulatory Compliance goal.
- Reads and incorporates into practice the policies and procedures for Compassus.
- Articulates the framework for regulatory compliance from federal perspective and the application/ implications for the Director of Revenue Cycle.
- Adheres to company expectations for the protection of confidential information.
- Ensures compliance with all applicable laws, rules, and regulations; and reports any and all suspected non-compliance.
- Creates a compliance-conducive environment in which company policies and procedures are the operating norm.
- Models leadership and compliance in all circumstances related to protecting patient, family, colleague, and company confidential information.
- Contributes as necessary to internal and external surveys, audits, and investigations, providing truthful and accurate information.
- Functions as an expert advisor to colleagues for compliance-related information.
Colleagues Pillar of Success
- Engages all colleagues in the Colleagues goal.
- Works collaboratively in a team environment.
- Promotes effective communication and seeks solutions to concerns raised.
- Attracts, hires, and retains the best colleagues.
- Creates a positive climate in which each colleague feels highly valued, involved, and engaged; productivity is fostered; quality and service are promoted; and our “employer-of-choice” reputation is advanced.
- Promotes an open-door policy, direct communications, trust among the team, and respect for the needs of each individual as a person, in order to achieve a high-performing work team.
- Champions regular, effective communications in one-on-one and group settings, using both listening and speaking skills to promote deeper understanding, collaborative problem solving, and team effort towards a common goal, thereby optimizing colleague engagement and retention.
- Communicates well horizontally, vertically, and within the matrixed organization.
- Demonstrates a caring connection with all colleagues, treating everyone with compassion, dignity and respect.
- Handles difficult situations with composure and assists colleagues with their work-related stress.
- Gives frequent and appropriate feedback, coaching, and mentoring, recognizing and rewarding strong performance, and helping colleagues develop and accept accountability for their performance.
- Effectively manages poor performance with feedback and guidance; removes colleagues who do not conform with policy or have consistently low performance in a fair, timely, and compassionate manner.
- Engages Human Resources as a strategic business partner, maximizing HR tools to achieve the desired culture.
- Exhibits personal commitment to continuous learning, soliciting and incorporating 360º feedback.
- Supports and encourages colleagues’ continuous learning, helping them grow, improve, and change.
- Integrates change management strategy when planning changes.
- Partners with Human Resources as appropriate in recruitment, hiring, discipline, and discharges to ensure legality and consistency with policies and procedures.
Quality Pillar of Success
- Engages all colleagues in the Quality goal.
- Leads with compassion, integrity, and excellence.
- Reflects, prepares, plans, and executes with excellence the “first time, every time.”
- Understands core issues and provides logical solutions.
- Engages subject matter experts and stakeholders, and leverages their input to arrive at the best solution.
- Ensures colleagues have all necessary experience, training, and credentials to deliver excellence.
- Solicits feedback from internal and external customers and responds appropriately to feedback in the interest of improving quality.
Service Pillar of Success
- Engages all colleagues in the Service goal.
- Prioritizes and promotes the Compassus mission, exemplifying its promise in all actions and attitudes.
- Always seeks to exceed the customer’s expectations, serving everyone with dignity and respect.
- Responds to internal and external customers with a sense of urgency.
- Follows through with commitments made to customers.
- Solicits feedback from internal and external customers and responds appropriately to feedback in the interest of improving service.
Growth Pillar of Success
- Engages all colleagues in the Growth goal.
- Demonstrates commitment to achieving goals and awareness of the impact of growth on care delivery.
- Assesses opportunities and develops local initiatives to achieve stated goals based on systematic analysis of supporting data and in concert with appropriate Company resources.
- Tracks and communicates progress toward goals.
- Assesses marketing needs, creates a plan, gathers resources, and executes.
- Schedules and presents education, informational, and marketing programs to area professional groups.
- Establishes professional relationships in the community, promoting the company to yield patient referrals.
Financial Responsibility Pillar of Success
- Engages all colleagues in the Financial Responsibility goal.
- Participates in the development of and adheres to the budget.
- Analyzes available data to make sound financial decisions, lowering/eliminating costs where possible.
- Makes efficient and effective use of time, colleagues, and other resources, balancing short-term results with long-term organizational health.
- Leads and provides direction for revenue cycle management and determines goals.
- Collaborates with staff to improve information documentation and implement the best practices.
- Reviews, designs, and implements processes surrounding admissions, pricing, billing, third party payer relationships, compliance, collections and other financial analyses to ensure that clinical revenue cycle is effective and properly utilized.
- Tracks numerous metrics related to the patient engagement cycle including record coding error rates and billing turnaround times to develop sound revenue cycle analysis and reporting.
- Manages relations with payers and providers to generate high reimbursement rates and a low level of denials.
- Oversees performance of end of episode reviews for Medicare and Non-Medicare clients.
- Oversees and performs (as applicable) claims audits for Medicare and Non-Medicare clients.
- Oversees the reviews and clears held claims (clears as applicable) due to varying reasons while coordinating with Clinical Team Manager, Scheduler, and Medical Records Coordinator, as needed.
- Oversees management of Un-signed orders and coordination with branch and sales staff.
- Oversees Reviews and Management of Coordination Notes regarding the following events: Biller Notification, Funding Source Change Request, Medicare Records Notification, and Seldom Used Payor.
- Runs necessary reports in both HCHB and Forcura for oversight of employee productivity and management of Unbilled.
- Coordinates with Branch Managers to address challenges and identify necessary support for financial success.
- Conducts Order/Claim investigation for Branch performance.
- Organizes practices for consistency to meet target objectives.
- Strategizes and develops corrective plans with team or individuals, as applicable.
- Provides leadership and direction in identification and resolution of operational barriers as it relates to efficient and compliant claim processing
- Responsible for the appropriate use of agency resources including but not limited to, supplies and personnel to ensure financial success.
- Works to maintain positive, collaborative relationships with patients, caregivers, referral sources, and/or physicians.
- Participates in internal staff meetings and training activities, as assigned.
- Collaborates with members of the marketing team to assist in identifying potential referral sources and patients appropriate for home care.
- Performs other duties as assigned.
KNOWLEDGE AND SKILLS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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