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Director Clinical Business Operations
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Information Technology company
ContractContract to Permanent
Information Technology company
$27 - $37 per hour
Largo, FL ( Map it )
No permanent US residency required
W-2 and C2C available
$27 - $37 per hour
Largo, FL
ContractContract to Permanent
This posting is no longer accepting new applicants

The Director Business Operations is accountable for the effective management of revenue cycle and supporting vendor / vendor relationships necessary to ensure the efficient billing of accounts and the timely collection of receivables; and the optimal recoupment of charges from third-party payers The incumbent will ensure business vendor partners are complying with all rules of the business; and ensuring performance metrics are being performed based on agreed upon SLA’s and contract terms. In addition, this person will be responsible for coordinating with IT staff to ensure that the necessary supporting applications, and IT infrastructure is operating in a manner to allow the vendor to perform its functions.

  • Collaborate with vendor and other Clinic staff to effectively execute plans; implement, manage, and evaluate operational programs, processes and initiatives related to patient billing, collection, reimbursement, revenue cycle management, customer service, and overall Clinic financial performance 
  • Provide leadership and management to ensure ongoing improvement of all key revenue cycle indicators; effectively managing external vendor contracts
  • Working with the Revenue cycle vendor, ensure compliance with contracts from multiple payers; maintain compliance with all applicable laws and regulations
  • Maximize claims edit functions within the software
  • Monitor the contractual compliance of claims payments; collaborate with the vendor and payers to obtain accurate reimbursement; and effectively work to resolve fee schedule disputes and other potential conflicts
  • Act as a business lead / integrator with the Clinic and GW IT staff to ensure that Clinic applications and infrastructure are performing to business standards
  • Working with vendor and internal Clinic staff, ensure business processes are efficient, collaborative, and patient friendly, and handle patient billing complaints, and any escalation of billing issues as necessary 
  • Responsible for compliance with all laws, regulations, policies and procedures, and required updates for medical group financial operations 
  • Develop processes to regularly review charges being recorded in the patient accounting systems to ensure they are timely, accurate and complete
  • Effectively work with department managers and others across the Clinic as appropriate to take corrective actions as necessary to ensure achievement of goals and objectives

Minimum Requirements:

  • Bachelor's degree in accounting, finance, business or related area or related field, or equivalent experience
  • Six years' experience working in a clinic, physician practice, or hospital patient financial services department - with a minimum of three years' experience managing a clinic, physician practice or hospital patient financial services/business office area
  • Professional work experience in, and knowledge of, revenue cycle, patient access, billing, collections, coding and accounts receivable management related to clinic, practice, or hospital
  • Demonstrated in-depth knowledge of CPT and ICD coding, billing, collections, and payment regulations within the healthcare industry required; strong knowledge of healthcare reimbursement methodologies, healthcare A/R, collections, insurance, government programs, 
  • Strong knowledge of all applicable compliance regulations and guidelines
  • Knowledge of, and experience in, several operational areas related to the revenue cycle to include health information management, patient access, clinical quality/case management, management information systems, accounting, and finance
  • Strong knowledge related to the flow of the revenue cycle, revenue cycle technology, and revenue cycle metrics, and key drivers
  • Demonstrated understanding of privacy, confidentiality, and security policies and procedures related to Protected Health Information (PHI) or other sensitive and personal information
  • Excellent interpersonal and communication skills with strong track record of success; demonstrated analytical and decision making skills
  • Ability to manage multiple priorities with deadlines; ability to plan, document, direct, monitor and coordinate work 
  • Knowledge of PCI compliance requirements 
  • Demonstrated successful leadership managing vendors/ vendor relationships 
  • Project management / leadership experience 


Preferred:

  • Professional certification in the Healthcare Financial Management Association (HFMA), NAHAM, AAHAM, or related professional organization 
  • MBA or Masters in finance 
  • Progressive financial leadership experience in medical group practice’s financial operations
  • Previous director level experience
Skills
Skill Proficiency Years Experience Percent Used
CPT
Any100%
Position Recruiter
Dino Lango
Technical Recruiter
dino@cloudteam.com
813-517-9520