This position is responsible for driving performance for all Ambulatory accounts receivable through the efficient management of claims submissions, billing, credit and collections, refund processing, and compliance functions for physician services to achieves designated reimbursement goals for the system. This position is also responsible for the strategy, transformation and optimization efforts through leading, defining, designing and integrating operations improvements across the Ambulatory Billing units system-wide. Leadership must include fostering strategic collaboration necessary to create high quality outcomes and superior customer service across clinical revenue cycle departments. Oversight includes Banner University Medical Group (BUMG) academic physician practices, Banner Medical Group (BMG), Banner Urgent Care (BUC) and other ancillary Physician related billing services. This position is also accountable for performance related to front office effectiveness, accounts receivable collections, patient and physician satisfaction, practice management application support, and support of system and regional physician strategies.
Essential Functions
Directs the staff and operations of the Ambulatory billing office (PBO). Ensures optimal performance through effective employee selection, training and development and performance management. Holds staff accountable for achieving plans and performance targets. Works with staff to identify and resolve the most complex issues and problems impacting the ambulatory billing office. Supports development and continued professional growth to meet company and individual goals for long-term success. Demonstrates an expectation for continuous quality improvement utilizing processes that include consideration of all stakeholders.
Continuously evaluates the effectiveness and efficiency of operations and implements or proposes optimization or transformation efforts. Manages the PBO related transformation plan and roadmap working with the transformation and optimization continuous improvement teams.
Develops and maintains strong relationships with clients. Through the effective selection, training and direction of staff, effectively manages relationships and business processes at all company physician offices and clinics and at all contracted physician offices.
Develops, implements and effectively manages policies, processes and procedures for the PBO and for clinic-based front office staff that result in maintaining accounts receivable days outstanding at or below goal levels. Provides education and policy updates for clinic and division employees, medical staff, patients and insurance companies on policy or procedures. Establishes and conducts performance reporting for revenue activities of each clinic. Works collaboratively with local CFO's, physicians, department heads, and practice manager(s) to develop and maintain a culture of high performance and accountability across organizational boundaries. Ensures appropriate coordination with the physician billing staff throughout account life cycle.
Provides regular revenue management reports to clients and management. Provides periodic status reports and ensures timely identification and reporting of potential risks to positive cash flow, public image, or legal compliance. Alerts senior management and operations leaders of such concerns in the areas of accountability.
Ensures compliance with government and commercial billing and medical record regulations and standards while maximizing reimbursement for patient claims. Works with company compliance and legal staff to maintain appropriate procedures and to represent the company in litigated matters.
Manages operational expenses in accordance with the budget. Directs and oversees the development of operating and capital budget for the department. Works with payor companies and agencies or other outside parties, including judicial and regulatory bodies, commercial payers, collection agencies, and auditors to address and resolve disputes and unpaid claims, develop procedures, or address other pertinent needs.
Implements system-wide programs and information systems to create and maintain functional capabilities that equal the best in the industry. Hold responsibility for implementation and the maintenance of the billing system throughout all company clinics, and the standardization of the policies and procedures involved in the management of the billing collection cycle. Provides ongoing leadership and operational oversight in the development, use and maintenance of the clinics information systems for billing and accounts receivable management.
Minimum Qualifications
Expert-level working knowledge of principles, practices, and operations in assigned area of responsibility as normally obtained through the completion of a Bachelors Degree in a relevant field and a minimum of five years of progressively responsible managerial experience in designated facility, business entity or area, including a minimum of two years management level experience within a major health care organization, health system setting, or large multi-operational corporate environment in complex industries similar to healthcare.
Depending upon assigned area of responsibility, position may require applicable certifications and/or licensures, including but not limited to: RN; MD or DO; Drivers License; Certified Healthcare Protection Administrator (CHPA); Certified Protection Professional (CPP); Chartered Property Casualty Underwriter (CPCU); Associate in Risk Management (ARM); CPA; SPHR; Registered Health Information Administrator (RHIA); Registered Health Information Technologist (RHIT); Certified Healthcare Facility Manager (CHFM); Certified Facility Manager (CFM); Certified Coding Specialist (CCS); Certified Professional Coder (CPC); JD from an American Bar Association accredited school; admission to a State Bar Association.
Must demonstrate expert-level knowledge and awareness of area of expertise in designated facility, business entity or area. Experience working in an integrated delivery system, multi-hospital system, or managed care organization in a management level position in assigned area of responsibility. Proven track record of driving successful performance outcomes and accomplishing organizational goals. Experience anticipating and responding to the needs of internal and external customers. Experience managing a budget. Strong financial and business acumen. Knowledge of budgeting and forecasting methodologies. Able to analyze and interpret data. Skilled in building partnerships with management, staff, and stakeholders to achieve department goals and objectives; managing problems and situations where uncertainty is inherent; developing strong, enduring, and trusting relationships; fostering the development of cohesive teams; persuading others to adopt a particular stance on an issue; developing and evaluating best practices and emerging trends for organizational applicability and appropriateness; constructing new and innovative solutions for complex and varying problems and situations while considering the larger perspective or context; mentoring and coaching staff by providing open and honest feedback to enhance performance; developing and implementing strategic goals and initiatives that support organizational success; effectively allocating available resources; utilizing data and information to make informed and appropriate decisions; negotiating win-win scenarios with internal customers and/or outside vendors/partners; developing collaborative relationships with internal and/or external strategic partners and/or other applicable parties. Excellent human relations, organizational and communication skills are essential. Leadership style and characteristics necessary to effectively perform in this role include: strong work ethic; results-oriented; persuasive; motivational; able to make rational decisions in difficult situations; inspirational; honorable; confident; systems-thinker; innovative; life-long learner; courageous; high-energy; integrity; collaborator; ability to work with teams; good listening; nonvolatile; values multiple disciplines; and passionate about continuously improving and providing high quality care and service excellence to patients, families, employees and physicians.
Preferred Qualifications
Master of Business Administration (MBA) or Certified Public Accountant (CPA) preferred.
Additional related education and/or experience preferred.
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.
