Join Orthopedic Specialists of SW Florida as Director of Revenue Cycle Operations, where you will play a crucial role in overseeing and optimizing the operational aspects of our Billing Department. With a focus on the oversight of the revenue cycle to maximize revenue utilizing the most innovative and effective processes

About OSSWF:

Orthopedic Specialists of SW Florida has been a cornerstone of orthopedic care in the Fort Myers area for over 23 years. Our practice boasts a team of 16 fellowship-trained orthopedic surgeons specializing in various subspecialities. We are committed to excellence and continued growth, offering comprehensive services including onsite Physical Therapy/Occupational Therapy, MRI, and digital X-ray. We prioritize patient care and strive for the highest standards of service.

Orthopedic Specialists of SW Florida’s state-of-the-art, 60,000 square-foot facility incorporates the latest in leading-edge technology in order to provide optimal care for patients who have bone, joint, muscle and spine problems. Our office includes five Centers of Excellence and a full Physical Therapy and Occupational/Hand Therapy division, which work in close coordination with our physicians to provide non-operative, preoperative, post-operative and preventive care.

Responsibilities:

The Director, Revenue Cycle Operations will be responsible for managing Orthopedic Specialist of SW Florida medical billing, insurance and patient collections and related support activities
Initial priorities will include developing the strategic vision, selecting third-party billing partners and executing billing initiatives
Future priorities will include fine-tuning the operating activities to optimize revenue collections as well as develop key service and support metrics
In this role, the Director, Revenue Cycle Operations will work closely with executives, directors, physicians, and managers as well as third parties
Hands-on management of all billing programs, systems, processes, and third-party vendors to ensure accurate, timely and well-controlled activities related to billing, collections, education, and support
Prepares daily, weekly and monthly RCM reporting metrics to remediate any items outside established KPI including status report of projects
Effectively implement denial management reduction through process improvements, coordinating direct or indirectly, with internal team and offices to improve workflows and provide training and education
Maintain understanding and communicates payor policy changes across the market
Responsible for Worker’s compensation relations and statutory changes
Promote positive attorney relations, stay current with PIP laws, and negotiate personal injury case settlements
Meet with payor representatives for timely remediation of large denial or underpayment projects
Formulate and execute policies and procedures to ensure the billing workflow is highly effective
Daily reviews of the following programs: Incoming claim/denial volumes, daily billing, rejections, evaluate clean claim rates, and team workflow
Presents first-line negotiation of payer contracts on an annual basis to the CEO and CFO
Evaluate and communicate fee schedule changes, or changes that affect payments annually
Annual charge master analysis and implementation
Develops quality control program to meet the company's quality initiatives
Ensure productivity goals are monitored and quickly re-mediates barriers to achieving those goals at the individual and/or team level
Counsels and disciplines employees in accordance with department goals and policies
Maintain compliance with directives from all regulatory agencies and third parties
New provider onboarding, train on billing processes, also working in coordination with credentialing supervisor
Ensure staff compliance with coding, PCI, insurance company policy changes
Collaborate with other departments to maximize training and efficiency
Maintain department compliance with state and federal regulations
Required to attend all executive meetings
Attend conferences pertaining to orthopedics or billing at the discretion of the CFO

Minimum Requirements (education, experience, special skills and licenses or certifications required):

10+ years of managerial experience in healthcare revenue management cycle roles with experience in all phases of the revenue cycle management. Orthopedic experience preferred.
Experience with Modernizing Medicine EMR and billing system preferred
Experience with a large group, growing healthcare organization support
Extensive knowledge of patient registration, coding, billing, regulatory requirements, billing compliance, business operations, financial systems and financial reporting
Strong work ethic, attention to detail, knowledge of the claims process, coding, billing, collections and credentialing

Benefits:

Competitive Pay
Generous PTO Allowance
6 Paid Holidays
401K
Affordable Medical, Dental, & Vision Insurance and more!

Additional Comments:

Drug Screening is required
Orthopedic Specialist of SW FL. participates in E-Verify
Criminal background screening mandatory
"Applicants have rights under Federal Employment Laws" Family and Medical Leave Act (FMLA) Poster; Equal Employment Opportunity (EEO) Poster; and Employee Polygraph Protection Act (EPPA) Poster.

Orthopedic Specialist of SW Florida is an Equal Opportunity Employer & Drug Free Workplace. 14601 Hope Center Loop, Fort Myers, Fl. 33912

Orthopedic Specialists of SW Florida

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Director of Revenue Cycle