The Director of Business Operations supervises, directs or coordinates all aspects of NTACHC operations that relate to the revenue cycle, assuring that revenue collection is maximized. The DBO is responsible for maximizing the collection of the medical service payments and reimbursements from patients, insurance carriers, financial assistance companies and guarantors. The DBO directly manages the functions of patient access and billing/collections, works collaboratively with the clinical team on documentation and coding, coordinates payer relations/contracting and other business operations relationships and contracts. This is a hands-on position requiring visibility with front office and back office staff as well as communicating with the management team members, providers and support staff.
Provide leadership, direction, and functional management in the position’s duties with utmost customer care, compassion, and integrity in supporting the quality of care for the patients and the community.
Full-time, goal-oriented, revenue-driven, highly accurate and motivated biller and leader who will establish and maintain strong relationships with providers, clients, patients and fellow staff.
Excellent and competitive benefits package offered which includes medical, dental, vision, disability and life insurance. Company matching retirement plan and generous paid time off to include vacation and sick leave accruals starting from the date of hire.
- Manage, supervise and direct key functions:
- Patient Access: Direct Call Center operations, patient scheduling, registration, financial screening/insurance verification, point of care collections.
- Payer Relations: Work with outside vendor to maintain payer contracting and provider enrollment; manage processes to assure electronic billing functions and claims resolution.
- Provider/clinical relations: coordinate with CMO and nursing administration to assure that medical record documentation, coding and charge capture processes work to maximize revenue.
- Billing: Manage processes for efficient and timely claims submission, payment posting, patient account collections, insurance follow-up and appeals.
- Business relationships: Coordinate with outside vendors related to patient services, clinic processes and revenue cycle, assure that contractual terms are met on both sides, process invoices and resolve business operational concerns.
- Maintain critical structure and environment.
- Maintain electronic practice management system, perform insurance/payer profile management, routine file maintenance.
- Monitor, report and improve performance in key functional areas.
- Analyze claims and denial data.
- Maintain cash management procedures and securing cash collections.
- Provide management with revenue cycle status reports and metrics.
- Establish and monitor goals and benchmarks.
- Develop and maintain appropriate internal policies and procedures.
- Develop systems and procedures to improve the quality and efficiency of the revenue cycle function.
- Effectively supervise and direct assigned personnel
- Participate in recruiting, interviewing, hiring and on-boarding of staff.
- Completes operational requirements by scheduling and assigning employees, following up on work results.
- Engage in staff performance coaching, evaluation and feedback, and as necessary disciplinary action.
- Address and resolve staff interpersonal conflict.
- Provide for initial and ongoing training and development in key functional areas.
- Approve time off and process payroll for direct reports.
- Comply with State and Federal Regulations and program requirements.
- Stay up to date on laws, regulations and requirements for key functional areas, and serve as content expert in these areas to the organization.
- Participate in audits (internal and external) and compliance/survey activities as required.
- Ensure all billing activities are consistent with protocols and in compliance with government and payer regulations.
- Participate as a part of the organization’s management team to effect continuous improvement in all aspects.
- Uphold and ensure compliance and attention to all company policies and procedures as well as the overall mission, vision and core values of the organization.
- Perform as a team player and leader.
- Communicate professionally in writing and verbally with all staff throughout the organization.
- Work cross-functionally with all internal departments to answer questions, resolve problems and better prepare staff for success.
- Develop and maintain favorable internal relationships and partnerships with co-workers.
- Designs and implements office policies by establishing standards and procedures, measuring results against standards, and making necessary adjustments.
- Other duties as assigned.
- Ability to recognize and respect cultural diversity of patients and staff.
- Recognize and respond effectively to verbal, nonverbal, and written communication.
- Ability to follow established policies and procedures dealing with health care.
- Must respect the confidential nature of medical information.
- Working knowledge of standard concepts, practices, and procedures.
- Professional manner and appearance.
- Good telephone etiquette and organizational skills
- Capable of using good judgement to plan and accomplish goals.
- Bachelor’s degree in any finance, business, health care administration or related field from an accredited institution.
- Experience with FQHC billing and revenue cycle activities.
- 5 plus years of medical practice revenue cycle management experience required, experience with NextGen preferred.
- 3 plus years of supervisory experience.
- Strong knowledge of clinical practice and revenue cycle management including third party reimbursement guidelines and procedures.
- Strong knowledge of CPT and ICD coding and related regulations and guidelines.
- Certified Professional Coder (CPC) or other medical coding certification a plus.
- Experience working with data, creating reports and analyzing information to make recommendations and changes.