Sharp HealthCare System Director Revenue Cycle - Access Services in San Diego, California

Key Responsibilities:

  • Review and design of processes that impact the revenue cycle across clinical and financial systems. Ensures that revenue integrity is established and preserved through all phases of system implementations, upgrades and maintenance. This includes creation, validation and reengineering of business/patient workflows that result in revenue generation and documentation required to support claim submission.

  • Works closely with operational and technical teams and acts as a bridge to communicate functional needs, create tools and opportunities for improvement that support revenue cycle best practices in an integrated environment.

  • Primarily focused on integration between the EHR, ADT, and HPA systems, but not limited to those systems – the Director ensures that workflows designed by various operational and technical teams are compatible and fully validated for efficient and safe results. Process designs leverage technology, promote first touch success for each user, and include controls to ensure timeliness and accuracy.

  • Provides leadership to a variety of system projects and initiatives that impact the revenue cycle. This includes leading and participating on workgroups for Teletracking (centralized bed placement), ICD10, ADT/AR upgrades, EDI transaction development, and implementation of insurance eligibility and payer notification processes. Supports initiatives of clinical documentation improvement, front end speech implementation, medical necessity status determination and alignment between physician order/accommodation code/claim payment request, and accountable care organization development.

  • Ensures the optimal and standardized use of front-end solutions for Patient Access Services to produce a zero-defect and fully compliant claim within 3days of discharge. Front-end solutions currently in use include hold bills/alerts, integrated electronic eligibility, financial status/application referral evaluation and reporting.

  • Implementation and standardization of hospital ambulatory revenue management system application (ARMS) in conjunction with revenue cycle team, fully utilizing the advanced beneficiary notice, correct coding initiative/outpatient edits, and department communication tools. Implement ABN/NEMB process in all appropriate clinical settings.

Customers Served:

Patient and Family Members, Physicians, Patient Access and Patient Financial Services, Case Management, Information Technology, Health Information Management, Corporate Compliance, Finance, Community Agencies.

Compensation and Benefits:

The System Director, Revenue Cycle Access and Service Standards position provides a very competitive compensation, including opportunity to participate in a system-wide incentive program along with a generous benefit package.

Physical Requirements

Ability to speak and hear clearly

Ability to make presentations to physicians, executives and staff.

Walk or sit at least 50% of the time

Driver’s license for transportation between facilities

Additional physical requirements may be discussed during the interview

About Sharp HealthCare

Sharp HealthCare is a not-for-profit integrated regional health care delivery system based in San Diego, California. Sharp includes four acute care hospitals, three specialty hospitals, two affiliated medical groups, a health plan, plus a full spectrum of other facilities and services. Serving a population of approximately 3 million in San Diego County, Sharp has more than 17,000 employees and 2,600 affiliated physicians on medical staffs, and operates 1,867 beds. The Sharp Experience is our unique, system wide commitment to transforming the health care experience in San Diego by becoming the best place to work, practice medicine and receive care.

Sharp HealthCare Awards and Recognitions

Sharp HealthCare Benefits

“Sharp HealthCare is proud to be an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, gender identity, transgender status, sexual orientation, protected veteran status or any other protected class.”

Keywords: Director, Revenue Cycle Access, Hospital Revenue Cycle, Patient Financial Services, Hospital Patient Access, HPA, PFS, ADT, AR, ICD10, HFMA, CAHAM, Sharp HealthCare jobs, Revenue Cycle jobs, Healthcare job, Executive jobs

System Director, Revenue Cycle Access and Service Standards –

Sharp System Services

Summary:

The System Director of Revenue Cycle Access and Service Standards is responsible for ensuring the functional alignment of financial and patient service standards and the resulting workflows to support optimal revenue cycle outcomes. The System Director works closely with Information Technology, Health Information Management, Patient Access and Patient Financial Services, Case Management, Bed Placement, Corporate Compliance, Finance, and Clinical Informatics to achieve the integration of business and clinical processes. The System Director works collaboratively across business units and teams, building consensus and developing strategic vision for system initiatives, regulatory mandates and complex projects, implementation and standardization of best practices for both revenue cycle metrics and service metrics, ensuring that the hospital revenue cycle is preserved and improved at all phases.

Required Skills and Qualifications:

  • 10 years of progressive revenue cycle management in an integrated healthcare environment with experience in all phases of hospital revenue cycle

  • 10 years of technical experience working with ADT/AR, EHR, coding and ancillary systems

  • Expert ADT and HPA knowledge

  • Extensive knowledge of billing compliance and regulatory requirements for Title XXII, JCAHO, CMS, OSHPD

  • Extensive knowledge of regulatory requirements impacted by Access and Financial Service staff including, but not limited to Medicare Conditions of Participation, HIPAA, PHI, Fair Pricing, and EMTALA.

  • Extensive knowledge of patient accounting systems, admitting and registration processes, and billing and collection processes.

  • Understanding of processes and risks of combining/merging patient records and identities

  • Familiar with ICD10 and CAC (Computerized Assisted Coding)

  • Understanding of both Business and Clinical processes affecting Revenue Cycle and Patient Satisfaction

Preferred Skills and Qualifications

  • Case Management Background beneficial

Education:

Bachelor of Science in Business Administration or related degree required.

Master’s Degree in Business or Public Health preferred.

Job: *Executive Jobs

Organization: *85660 - Centralized PAS Support

Title: System Director Revenue Cycle - Access Services

Location: San Diego-Spectrum

Requisition ID: 80819