Director, Billing & Collections PRMO

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.

About Duke Health's Patient Revenue Management Organization

Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.

The Director, Hospital Billing & Collections, PRMO provides system-wide oversight for the insurance billing and collections of all hospital/technical services across DUHS.

The Hospital Billing & Collections department includes Insurance Billing, Insurance Collections, Denials, Analytics, Transplant Billing & Collections, and Underpayments. The Director ensures that all operations align with PRMO and DUHS goals and initiatives. The Director leads the department in a manner that is patient-centered and respectful of all employees and stakeholders, including modeling of Duke's Values and Behaviors.

Duties and Responsibilities of this Level:

A. Plan, direct and coordinate all activities of Hospital Billing & Collections

• Identify, communicate and align overall strategy for department improvement across the system. Develop departmental strategies to meet PRMO and DUHS goals and performance metrics.
• Work with entity leadership, departmental managers, revenue managers, and physicians to identify opportunities for improving revenue cycle performance and metrics associated with insurance collections, days in accounts receivable outstanding, aging of accounts receivable, claims denials, and avoidable write-offs.
• Formulate and administer system level policies and procedures; ensuring compliance with state and federal regulations, and all payor requirements.
• Maintain working knowledge of insurance billing, collections, registration, and support management team on resolution of issues affecting department.
• Review monthly trending analysis of Billing & Collections departments to effectively communicate and message performance to leadership constituents across DUHS and provide feedback/guidance to management team about areas of focus for performance improvement.
• Monitor Hospital Billing & Collections internal control performance across the system.
• Ensure management compliance with documented and established workflow guidelines and procedures.
• Serve as expert on institutional questions related to industry and payor regulations related to Hospital Billing & Collections. Engage with other departments as needed to ensure compliance.
• Actively direct outsourcing and system vendor relationships. Monitor cost and evaluate utilization of any vendor relationships assigned to department cost center.
• Take leadership role in technology implementations affecting department. Assist in identification of new technologies that will improve financial service operations.
• Serve as an internal consultant on hospital billing & collections issues with Duke Medicine and PRMO leadership.

B. Serve as part of the overall leadership team of the Patient Revenue Management Organization as it relates to providing input on the overall strategy and vision for the Revenue Cycle

• Develop and achieve PRMO goals that support overall system goals.

• Develop and promote PRMO strategic vision, mission, and purpose while emphasizing teamwork and results.

• Effectively define relevant "customers" for department management and staff. Utilize trending tools and communication plan for departmental staff related to customer service measures. Ensure measurable customer service standards are part of every employee's expected job results.

• Create and foster a department culture that provides a satisfying and enriching environment in which staff can be developed and retained. Support the PRMO Work Culture Initiatives to improve reward and recognition programs

• Maintain liaison with clinical and departmental staff, and DUHS entities as it relates to Financial Services operations.

• Interpret entity and PRMO specific reports relating to departmentperformance, staff performance, financial performance and ensure appropriateaction plans are executed.

C. Primary responsibility for administrative functions for Hospital Billing & Collections including: budget development and management, departmental work culture development/maintenance; mentoring, coaching of direct reports

• Approve departmental budgets. Ensure appropriate use of all resources.
• Communicate budget results to management staff and assist in budget management.
• Support and approve system process improvements to decrease costs and improve service for applicable stakeholders
• Ensure provision of education and training to management and staff employees in areas relevant to Billing & Collections policies and procedures
• Monitoring and provision of information on local, national, and international trends in healthcare delivery
• Monitoring and provision of information regarding changes in legislation and accreditation standards that affect Hospital Billing & Collections

Manage human capitol and resources-onboarding, succession planning, recruitment strategies and employee engagement

Required Qualifications at this Level:

Education: Bachelor's degree required. Master's degree preferred.

Experience: 8 years progressive management and/or consulting experience in a healthcare environment is required, of which 5 of those years should be in management of people or projects.

Degrees, Licensure, and/or Certification: Patient Accounting certifications preferred.

Knowledge, Skills, and Abilities:

Technical: Solid understanding of all departmental related functions - principles and practices of hospital billing and collections activities. General understanding of all revenue cycle functions and interrelationships. Knowledge of Federal, state and local regulations governing patient access activities. Experience in process improvement. Experience in budgeting.

Non-technical: Strong leadership presence and skills. Proven capabilities in building and leading teams. Ability to work with others in a cooperative, collaborative manner. Strong written and oral communication skills.

Systems:

• Epic experience preferred
• MS Office Applications (Word, Excel, Visio, PowerPoint, Access)
• Kodiak RCA