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
