Revenue Cycle Director, Liaison (Pediatrics & Dermatology)

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to departmental budgets, qualifications, experience, education, licenses, specialty, and training. The above hiring range represents the University's good faith and reasonable estimate of the range of possible compensation at the time of posting.

Position Summary

The Director is part of a team of end-to-end knowledge experts serving as members of the liaison team facilitating collaboration between the assigned department(s) and the CRO.

The role is responsible for overseeing internal client engagement and satisfaction for their assigned units, including smooth workflow of revenue cycle operations, continuous improvement initiatives, and monitoring performance against key performance indicators, set targets, and service agreement standards.

Responsibilities

Operations

• Primary point of contact for assigned local departmental leadership, the CRO, vendors, and other key areas to ensure proper oversight of revenue cycle activities.
• Oversees satisfaction across assigned department (s), offer clarity on accountability and offer operational support as it relates to the success of the Revenue Cycle.
• Supports process improvement opportunities, coordinates resources, and ensures support from all appropriate areas.
• Ensures efficient communication and collaboration between department and CRO for optimal coordination of key functions for optimal workflows related to financial clearance, revenue integrity, coding, and AR follow-up.
• Fosters relationships and manages expectations by coordinating communication and keeping leaders up to date on projects and results inclusive of onboarding new practice leaders
• Works to resolve complex matters, assess root cause analysis, and facilitate lessons learned for issues adversely impacting departmental revenue cycle, including but not limited to discrepancies in data, pre-authorizations, coding, or delays in claims payment processing.
• Audits workflows for efficiency and optimization, including examining the processes for submission, review, and management of local documentation, such as letters of medical necessity.
• Escalates and makes recommendations on issues impacting the department, such as coding, charge correction & provider charge capture (missing or lagging charges) and ensures agreed upon plan is completed in a timely manner.
• Partners with internal and external partners to ensure that units' revenue cycle operations align with the needs and functions of the organization. Ensures that priority matrix for work is adhered to in alignment with established service level agreements and departmental needs.
• Ensures proper management and handling of work queue inventory for multiple rates of collection, and potential backlog to make data-driven recommendations to leadership.
• Collaborate with EpicTogether to resolve logic issues to prevent future delays or denials.
• Partner with CRO leadership and experts to exchange information and trouble shoot issues.
• Keeps apprised of rules and regulations affecting reimbursement. Stays current through appropriate journals and personal contacts of such developments in the industry and informs departmental clients of impact.

Strategic

• Partners with CRO and Departmental physician and administrative leaders to prioritize key performance indicators, streamline, implement performance improvement initiatives, and lead change management efforts as needed.
• Utilizes electronic medical record dashboards and reports to monitor key performance indicators of operational workflows to ensure a holistic view of Revenue Cycle activities for all liaison unit departments.
• Evaluates data to identify trends and gaps across Revenue Cycle processes. Uses analysis to make recommendations for improvements and optimization. Participates in improvement / optimization initiatives.
• Preparation and monitoring of procedures for underpayment appeals for payors, including development of key metrics, identification and remedy of underpayment trends with establishment of timetables and tracking mechanisms for such resolution and payment, i.e., root cause analysis and follow up via meetings and discussions with payors.

People

• May supervise Associate Director(s) as assigned.

Compliance and Other

• Maintain current knowledge regarding reimbursement mechanisms within the healthcare industry. Prepare and present updates on reimbursement, contracting issues and reimbursement strategy to departments and CRO leadership.
• Conform to all applicable HIPAA, Billing Compliance and other pertinent regulations.
• Participates in committees, task force, and work groups.

All other duties and projects as assigned.

Minimum Qualifications

• Bachelor's degree or equivalent.
• Seven (7) years plus experience in health care and revenue cycle.
• Thorough knowledge of project improvement management processes and project management.
• Knowledge of healthcare industry revenue cycle, reimbursement, and payer contracting strategies and trends.
• Proficiency in database, business intelligence and spreadsheet applications including COGNOS and MS Excel., computer hardware and software operating systems.
• Knowledge of IDX and relational database systems.
• Ability to communicate effectively in both oral and written form. This position requires the ability to interact positively, constructively and effectively with employees, professional staff, community representatives and carriers.
• Ability to work independently with follow-through and handle multiple tasks simultaneously.
• Ability to work collaboratively and promote team building with a culturally diverse staff and patient / family population.
• Must be a motivated individual with a positive and exceptional work ethic.
• Proficiency industry knowledge in data management

Preferred Qualifications

• Master's Degree preferred
• Epic experience is preferred.
• Prior supervisory experience is preferred.

Competencies

Patient Facing Competencies

Minimum Proficiency Level

Accountability & Self-Management

Level 4 - Advanced

Adaptability to Change & Learning Agility

Level 4 - Advanced

Communication

Level 4 - Advanced

Customer Service & Patient Centered

Level 5 - Expert

Emotional Intelligence

Level 4 - Advanced

Problem Solving & Decision Making

Level 4 - Advanced

Productivity & Time Management

Level 5 - Expert

Teamwork & Collaboration

Level 4 - Advanced

Quality, Patient & Workplace Safety

Level 5 - Expert

Leadership Competencies

Minimum Proficiency Level

Business Acumen & Vision Driver

Level 4 - Advanced

Performance Management

Level 4 - Advanced

Innovation & Organizational Development

Level 4 - Advanced

Equal Opportunity Employer / Disability / Veteran

Columbia University is committed to the hiring of qualified local residents.