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Corporate Director, Billing Optimization
full-timeFarmers Branch

Summary

Location

Farmers Branch

Type

full-time

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About this role

Overview

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360 outpatient locations in 14 states providing more than 2.5 million patient visits annually. It is one of the nation’s leading health systems with nearly 57,000 employees and physicians. Eighteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

 

Responsibilities

The Corporate Director of 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. Through strategy development, aligning the annual initiatives and collaboration, 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. The Director is accountable to the VP of Outsourcing and Strategic Initiatives for timely reports and updates relating to key initiatives, delivering successfully on timelines, as well as effective management of staff and delivery of appropriate productivity and quality parameters if the Director has direct reports.

 

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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.
  • Prior working experience within Supervisory/ Management capacity, specifically with Billing Integrity, Revenue Integrity, and Billing Process, includes managing the billing for all payors, includes managing bridge routines.
  • Prior experience in implementing clearing houses and preferably rollout of EPIC program in a large hospital setting.
  • Ability to envision and execute; process and policy changes, change in corporate culture, alignment between enterprise strategy and individual business channel needs.
  • Proven ability to effectively interact with key stakeholders, hospital leadership and other team members, while maintaining standard of professional business service
  • Strong communication and relationship management skills.
  • Ability to form collaborative working relationships.
  • Strong analytical and problem-solving skills. Ability to review weekly, monthly metrics – leading and lagging KPIs and own action plans. Proven ability to make logical correlations between data points to determine if analysis is accurate.
  • Ability to envision and execute; process and policy changes, change in corporate culture, alignment between enterprise strategy and individual business channel needs.
  •  

    Preferred qualifications:

  • Proficiency with IT hospital revenue cycle tools like CHC / Relay Assurance (also known as ePremis, now part of Optum), EPIC, Meditech.
  • Advanced knowledge and management of bridge routine files – writing and modifying, CCI edits, 835, EFT, ERA, and claim error trends across multiple payor base and across states.
  • Meditech and EPIC: basic navigation of systems as a minimum.
  • Employment Status

    Full Time

    Shift

    Days

    Equal Employment Opportunity

    Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOCKnowYourRightsscreenreader10_20.pdf

     

    Other facts

    Tech stack
    Revenue Cycle Management,Billing Optimization,Stakeholder Management,Analytical Skills,Problem-Solving,Communication Skills,Relationship Management,Process Improvement,Change Management,Data Analysis,Billing Integrity,Revenue Integrity,EPIC,Meditech,KPI Management,Standard Operating Procedures

    About Prime Healthcare Management Inc

    About Prime Healthcare and Prime Healthcare Foundation: Prime Healthcare is an award-winning health system operating 51 hospitals and more than 360 outpatient locations in 14 states, providing over 2.5 million patient visits annually. It is one of the nation's leading health systems, with nearly 57,000 employees and affiliated physicians. Eighteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Based in Ontario, California, Prime Healthcare is nationally recognized for award-winning quality care and has been named a 10 Top and 15 Top Health System by Truven Health Analytics. Its hospitals have been named among the nation's "100 Top Hospitals" 69 times and have received more Patient Safety Excellence Awards from Healthgrades than any other health system in the past eight years. To learn more, please visit primehealthcare.com.

    Team size: 10,001+ employees
    LinkedIn: Visit
    Industry: Hospitals and Health Care

    What you'll do

    • The Corporate Director of Billing Optimization is responsible for the strategy, management, and implementation of the Enterprise Billing Program. This includes partnering with revenue cycle and business office leaders to optimize billing operations and improve key performance indicators.

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    Frequently Asked Questions

    What does a Corporate Director, Billing Optimization do at Prime Healthcare Management Inc?

    As a Corporate Director, Billing Optimization at Prime Healthcare Management Inc, you will: the Corporate Director of Billing Optimization is responsible for the strategy, management, and implementation of the Enterprise Billing Program. This includes partnering with revenue cycle and business office leaders to optimize billing operations and improve key performance indicators..

    Why join Prime Healthcare Management Inc as a Corporate Director, Billing Optimization?

    Prime Healthcare Management Inc is a leading Hospitals and Health Care company.

    Is the Corporate Director, Billing Optimization position at Prime Healthcare Management Inc remote?

    The Corporate Director, Billing Optimization position at Prime Healthcare Management Inc is based in Farmers Branch, Texas, United States. Contact the company through Clera for specific work arrangement details.

    How do I apply for the Corporate Director, Billing Optimization position at Prime Healthcare Management Inc?

    You can apply for the Corporate Director, Billing Optimization position at Prime Healthcare Management Inc directly through Clera. Click the "Apply Now" button above to start your application. Clera's AI-powered platform will help match your profile with this opportunity and guide you through the application process. You can also learn more about Prime Healthcare Management Inc on their website.