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Position Details

Department: Transplant Rev Cycle
Category: Director/Management
Location: Phoenix
Posting #: 464623
Date Posted: 8/1/2019
Employee Type: Regular

Position Summary

The Director of Transplant Revenue Cycle is responsible for the financial operations and business services for all transplant related programs and services, including oversight responsibilities for compliance with regulatory, accrediting, and third party payer regulations and standards. Oversees the timely, seamless, and accurate financial clearance for all inpatient and outpatient transplant related services and directly manages challenging cases. Partners with the Vice President, Transplant Services and others relevant parties across the system to provide oversight for the transplant patient revenue cycle including management of patient accounts to align with payor requirements. Collaborates with the Managed Care department to ensure the sharing of insurance plan updates, coordination of coverage, and negotiation of single case agreements. Assists with the Medicare Cost reporting process and time studies. Oversees accounts payable for donor acquisitions and searches, NMDP, DNAZ and other outside providers. Directly supervises the Transplant Financial Coordinators, Patient Account Representatives, Transplant Reimbursement Specialists, and fosters a team dynamic of excellence and service. Maintains knowledge of all relevant systems including OTTR, SCM, UNOS and ensures the competency of the Transplant Financial Coordinators and Patient Account Representatives.

PCH Values

  • Family-Centered care that focuses on the need of the child first and values the family as an important member of the care team
  • Excellence in clinical care, service and communication
  • Collaborative within our institution and with others who share our mission and goals
  • Leadership that set the standard for pediatric health care today and innovations of the future
  • Accountability to our patients, community and each other for providing the best in the most cost-effective way.

Position Duties

  1. Manages operational activities.
    • Manages daily operational activities and support staff ensuring work flow processes are consistent within all applicable regulations, policies, procedural guideline and best practices for transplant revenue cycle operations. Directs, manages, and evaluates effectiveness and efficiency of authorizations, financial counseling, billing, collections, and cash posting for transplant services.
  2. Maintains transplant database.
    • Ensures OTTR and the transplant database are adequately updated and/or maintained. Prepares and distributes reports as needed to monitor key metrics.
  3. Maintains vendor relationships.
    • Establishes and maintains vendor relationships for purchased services by maintaining prompt and accurate payment for services rendered. Collaborates with contracting, compliance and legal in developing operational language to support purchased service agreements.
  4. Collaborates with all necessary departments to maintain compliance.
    • Works collaboratively with the Vice President, Transplant Services and numerous stakeholders to ensure transplant program remains financially viable and compliant with state and federal laws and regulations. This includes managed care contracting, finance, providers and clinical staff. Serves as point of contact for the Transplant Cost Report.
  5. Develops operating budget.
    • Responsible for the development of an annual operating budget for assigned areas that encompasses both current and future operational demands. Leads the fiscal oversight of allocated resources in order to optimize efficient and effective utilization of resources.
  6. Monitors Quality Assurance.
    • Monitors QA results and identifies opportunities by partnering with the training coordinator to implement solutions.
  7. Staff supervision and development.
    • Develops and supervises staff through provision of timely feedback and use of appropriate Human Resource policies and tools to facilitate and ensure the ability of staff to achieve highest level of professional growth and desired performance standards. This includes hiring and performance management of staff. Generates enthusiasm and commitment among team members to foster and reinforce team performance.
  8. Performs miscellaneous job related duties as requested.

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Position Qualifications

Please review the following qualifications and specify whether you meet each of the requirements listed.
Do you meet this requirement?
Education
1. Bachelors Degree in business, finance, health care administration or a related field. Required
2. Master`s Degree Preferred
Do you meet this requirement?
Experience
1. Five years revenue cycle experience, including hospital and physician billing and collections. Required
2. Minimum two years supervisory experience. Required
3. Previous transplant program experience, including awareness of CMS guidelines for transplant centers and regulatory billing requirements. Required
4. Experience with third party payer requirements, including Medicare and Medicaid. Required
Do you meet this requirement?
Special Skills
1. Advanced proficiency in data analysis using Microsoft Excel and other statistical packages, as well as knowledge of the functions and use of billing systems. Required
2. Ability to construct financial and other reporting models to assess and report performance. Required
3. Extensive knowledge of hospital and physician billing processes, knowledge of CPT and ICD-9/10 coding, A/R systems, and compliance and maintain knowledge of billing and other systems and their capabilities. Required
4. Must possess strong written and verbal communication skills. Required
Physical Requirements & Occupational Exposure/Risk Potential
1. Physical Requirement - Feeling (sensing textures and temperatures) Occasionally
2. Physical Requirement - Fine Motor Skills (pinching, gripping, etc) Occasionally
3. Physical Requirement - Hearing Constantly
4. Physical Requirement - Pushing/pulling Occasionally
5. Physical Requirement - Reaching Occasionally
6. Physical Requirement - Sitting Constantly
7. Physical Requirement - Standing Constantly
8. Physical Requirement - Stooping/crouching/kneeling/crawling Occasionally
9. Physical Requirement - Talking Constantly
10. Physical Requirement - Tasting/smelling Constantly
11. Physical Requirement - Walking Constantly
12. Physical Requirement - Near Vision Constantly
13. Physical Requirement - Far Vision Constantly
14. Physical Requirement - Color Discrimination Constantly
15. Physical Requirement - Use of keyboard, mouse and/or computer equipment Constantly
16. Physical Requirement - Lift up to 35 pounds without assistance Occasionally
17. Physical Requirement - Lift more than 35 pounds without assistance Occasionally
internal/external
I have reviewed the qualifications, physical requirements and occupational exposure/risk potential for this position and wish to apply