The VP Revenue Cycle Professional Billing reports directly to the Senior Vice President (SVP) Revenue Cycle and is responsible for all aspects of the Revenue Cycle Operations for professional billing. This executive is responsible for developing and executing a Revenue Cycle strategic plan to accomplish the professional billing goals of THR in partnership with executive leaders. This position will have responsibility for leading the Directors and Managers to ensure Revenue Cycle activities are the leading practice in the industry, and that all policies, procedures, and strategies adhere to the guidance and vision of the centralized Revenue Cycle function and THR.

The VP Rev Cycle Professional Billing has the following duties and responsibilities:

• Areas of responsibility include centralized Patient Access and Financial Clearance, Professional Coding, Professional Revenue Integrity, and Professional Billing Office insurance processes.
• Partners with THR leadership on Revenue Cycle process improvement, training, technology innovation, analytics, compliance, and vendor management.
• The Vice President of Professional Revenue Cycle Operations will continually review the current state and work with the Revenue Cycle leaders to move the organization to leading practices.
• The VP Revenue Cycle Professional Billing is responsible to ensure policies and procedures are current and enforced, business practices are compliant, and a high level of patient and customer satisfaction is maintained across the organization.
• Serves as a Revenue Cycle expert and resource to all professional entities across THR, is self-directed and requires minimal supervision.
• Develop, evaluate, monitor, and communicate the long and short term strategic objectives of the professional revenue cycle functions for THR, ensuring consistency and alignment with the strategic objectives of the organization. Responsible to achieve annual performance goals as established by the Chief Financial Officer, Senior Vice President Revenue Cycle, and THR.
• Develop and execute a detailed plan to improve the revenue cycle for professional billing and to continually improve financial clearance accuracy, coding accuracy, reduce days in AR, increase cash collections, reduce bad debt, eliminate write-offs due to revenue process issues and improve customer and patient satisfaction.
• Provide revenue cycle leadership to all clinics and practices. Provide leadership and supervision to the THR Professional Revenue Cycle management team.
• Partner with other departmental leadership to lead the development and implementation of policies, procedures, and workflows which impact net revenue cash flow or performance efficiency across the Professional Revenue Cycle function that align with the strategic direction and standardization for all of THR.
• Partner with system leadership to develop process improvement opportunities, training, technology innovation, analytics, compliance, and vendor management to meet THR Professional Revenue Cycle needs.
• Provides leadership in communicating consistent information and data regarding THR Professional Revenue Cycle performance.
• Collaborate with THR Contracting to understand contract specifics and provide THR Contracting with data to support negotiations with payers and development of contracting strategies for the THR market.

Essential Functions:

• Develop relationships and collaborate with leaders at the payer to improve appeal turnaround and dispute resolution.
• Manage and oversee the development of technology solutions to improve efficiencies and reduce the delays in workflow processes.
• Develop and ensure that all activities of the Professional Revenue Cycle are performed in accordance with state and federal regulations, mandated collection practices, all regulatory agencies including JCAHO, and are HIPAA compliant.
• Develop and monitor an annual operational budget as well as any capital budget requests and complete all fiduciary responsibilities of Professional Revenue Cycle.
• Exercise creative approaches to problem solving. Deals with conflict and problematic situations in an open and tactful manner.

Individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This role requires the ability to solve problems, think outside the box, and be resourceful; must be result-oriented, a quick learner and a self-starter. The requirements listed below are representative of the knowledge, skill, and/or ability required to build THR's culture for action.

Essential elements in the preferred candidate’s credentials and experience should include:

• Bachelor’s degree in Business Administration, Health Care Administration, or Clinical Administration required.
• Master’s degree in Business Administration, Health Care Administration, or Clinical Administration preferred.
• 10 years Professional Health System Revenue Cycle experience required; Epic Shared Business Office (SBO) experience preferred.
• 7 years’ experience at a director’s level or equivalent required.

Skills and Abilities:

• Proven ability to work collaboratively in group settings with various stakeholders, including executive leadership and clinicians.
• Knowledge of health care reimbursement policies
• Knowledge of and skill in managing complex operations across the revenue cycle, including physician and reference lab.
• Requires problem solving skills, critical thinking skills, and the ability to multi-task
• Extensive knowledge of health care financing, reimbursements, and revenue cycle practices
• Extensive working knowledge of Medicare and Medicaid regulations relevant to Revenue Cycle
• Proven ability to work collaboratively in group settings with various stakeholders, including executive leadership and clinicians.
• Knowledge of health care reimbursement policies.
• Knowledge of and skill in managing complex operations across the revenue cycle, including physician and reference lab.
• Requires problem solving skills, critical thinking skills, and the ability to multi-task
• Extensive knowledge of health care financing, reimbursements, and revenue cycle practices
• Extensive working knowledge of Medicare and Medicaid regulations relevant to Revenue Cycle
• Demonstrated strong written and verbal communication skills. Ability to listen actively and respond to employees, physicians, patients, and payer issues in a competent manner.