Prime Healthcare and Prime Healthcare Foundation comprise an award-winning health system operating 44 hospitals in 14 states.
Fourteen of Prime’s hospitals are not-for-profit members of Prime Healthcare Foundation. Prime is one of the nation's leading healthcare service providers, with nearly 45,000 employees and affiliated physicians dedicated to providing the highest quality healthcare.
Each of our hospitals serves the unique needs of their communities while providing exceptional care with the strength and support of Prime Healthcare.
Job Summary :
The Director of Implementation & Billing Optimization is responsible for the strategy, management and implementation of the Enterprise Billing Program, actively owning the portfolio across Revenue Cycle Management and drive optimization and improved metrics across the clearing houses.
The Director will partner with revenue cycle and business office leaders across all levels of the organization to execute goals and plans of reach / exceeding key performance indicators (KPI) relating to billing operations, which include but are not limited to : 837 files, billing edits, clean claim rate standards, billing errors and trends, as well as claim rejections and trends.
The Director will lead improvement efforts through execution of business objectives and strategic initiatives. The Director will provide issue resolution, develop and implement standard operating procedures (SOP) when needed, participate in go-live implementations to ensure successful transition, as well as provide effective communication and stakeholder management at all times.
Qualifications :
- Bachelor's degree (B.A.); a minimum of 8-10 years related experience and / or training; or equivalent combination of education and experience.
- Five (5) years of experience with acute hospital / facility revenue cycle setting.
- Working knowledge of the Revenue Cycle spectrum : Patient Access, Coding, DNFB, Billing, Collections
- Proficiency with IT hospital revenue cycle tools like CHC / Relay Assurance (also known as ePremis, now part of Optum), EPIC, Meditech.
- Bridge Routine Files writing and modifying, CCI edits, 835, EFT, ERA, and claim error trends across multiple payor base and across states.
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