Position Summary

 

The Director will assist in the creation and execution of the strategic direction and objectives which are necessary to build a best-in-class medical group.  In conjunction with MGC Executive Leadership, the Director will lead the conception and enhancement of growth initiatives, policy and procedure development, new service offerings, technology advancements, and budget proposals. The Director will possess innate abilities in building strategic and tactical business plans, exceptional administrative teams, and forging provider relationships that are cultivated through thought processes that are creative, collaborative, and decisive.

 

Minimum Requirements

 

Education           

Bachelor’s Degree in healthcare or Business Administration.

 

Experience        

Must have in-depth knowledge and skills in the areas of physician practice management, financial management, marketing, billing and information systems, and human resources. Needs to have demonstrated through experience that he/she is capable of building an operational infrastructure that can support current business and projected growth. Demonstrated general knowledge of billing and coding rules and regulations for governmental and managed care payers.  Minimum of five years of healthcare coding and billing management experience required 

 

License/Registration/Certifications       

CPC or CCS-P

 

Preferred Requirements

 

Preferred Education      

Master’s Degree in Healthcare Administration

 

Preferred Experience   

5-7 years of healthcare coding and billing management experience

 

Preferred License/Registration/Certifications   

CPC or CCS-P

 

Core Job Responsibilities

Provide leadership in the conception, planning, and development of strategies and objectives to support the organization’s strategic planning initiatives. Establish a business climate that will ensure success of the organization’s business. Can respond and execute swiftly with sound reasoning when making decisions that will have impact on the group as a whole.  Visible; gets out among the employees and providers at all levels in the organization. Recruit and select members of the management team to direct the affairs of the Medical Group.  Directs their activities and evaluates their performance.  Establishes formal means of accountability from those to whom he/she has assigned duties.  Provide appropriate staff support for the development of long- and short-term strategic plans. Directs the business and financial affairs of the organization by employing a system of accountability to ensure responsible fiscal management including accounting, budgeting, internal controls, and timely reporting. Reports regularly to MGC Executive Leadership on the operation and the performance of the coding services. Ensures that coding activities of the Medical Group are in compliance with all federal and state statutes.  Studies and presents to all members of the Medical Group ways of enhancing operational effectiveness, placing special emphasis on cost containment approaches to the extent possible without jeopardizing important innovation, progress, or quality of care. Represents the organization in its relationships with community businesses and civic associations, government agencies, and professional organizations. Responsible for all aspects of Professional coding processes/functions Monitor all Professional Coding dashboards, work-queues and reports necessary to identify coding and/or revenue cycle trends to develop and implement solutions to optimize revenue collections within the scope of responsibility Serve as the primary professional coding resource to our Medical Group leadership as it relates to professional billing and denials Work with Medical Group Directors on professional coding topics that effect revenue cycle performance, identify areas of improvement, and project manage new initiatives.  Develop and maintain an ongoing working relationship with Information Services’ team, to ensure coding works within the established billing systems and processes are configured/built in accordance with all requirements in order to ensure timely and optimal reimbursement. Monitor changes in laws and regulations and policies that impact clinical documentation, reimbursement, and coding to assure compliance. Provide leadership and guidance to management and supervisory teams to ensure accountability for employee competence, effectiveness as well as staff productivity performance  Must be able to work well with multiple departments and practices Lead process improvement initiatives to eliminate redundancies, reduce costs through process improvements, contract negotiations, and system consolidation/optimization. Ability to develop, prioritize, and accomplish goals. Ability to analyze and evaluate data and make appropriate decisions/recommendations based on trends Develop and administer actions plans in order to meet AOP and/or Annual Departmental goals.  Must possess a good working knowledge of the Resolute Professional Billing module within EPIC and be able to troubleshoot and identify root causes when processes are not functioning as expected. Must be self-directed, motivated, and able to work independently Must be flexible in responsibilities and work schedule NOTE:  These bulleted items are intended to describe the essential functions of the job and are not intended to be a complete list of all responsibilities.  Skills and duties may vary dependent upon our department.  Other duties may be assigned as required.