at SIU Medicine in Springfield, Illinois, United States
Job Description
Description
This position will provide system-wide direction and analysis intended to improve operations and revenues for the SIU Federally Qualified Health Center (FQHC) Programs consisting of 12 Medical and Behavioral Health Clinics, 1 Express Care Clinic and 4 Dental Clinics across central and southern Illinois. This position will be responsible for analyzing the FQHC Revenue Cycle, observing workflows and identifying inefficiencies in the registration and billing processes. The Deputy Director will report trends of errors, identify root causes, and create key performance indicators. The Deputy Director will work with the Director of Managed Care and the Director of Insurance Follow-up to analyze, review and develop practice strategies and recommendations on payers including Medicaid and Medicare Managed Care and Commercial insurances. This position will also provide recommendations on best practice in setting up new FQHC clinics and systems in the Athena/IDX practice management system and in utilizing the Azara DRVS system for dashboards and reporting UDS key performance indicators each year to the federal government.
Examples of Duties
85% Administration
Provide direction and set goals for the FQHC Revenue Cycle Teams around alternative payment models, denials, financial counseling and good faith estimate staff for all FQHC sites.
Perform annual analysis of collections versus expected reimbursement per major payer and payer plans.
Observe and analyze workflows and procedures to identify potential problem areas and develop a more streamlined processing procedure that increases efficiency while maintaining a high level of integrity within all FQHC sites including dental.
Compile and compose activity reports including work efficiency measures and trends for the unit.
Assist in performing analysis of write-off trends per payor.
Utilize denial reports to assess root causes and identify trends.
Monitor and track coding denial trends to help identify education/feedback opportunities.
Proactively monitor Revenue Cycle communications and payer websites.
Serve as liaison with third party payers for all FQHC sites and keep abreast of changes in policy or procedures.
Perform data analyses using Athena IDX, Power BI and DRVS and submit to the CEO and Governing Board to assist in decision analysis for projects.
Serve as financial analyst on projects as assigned by CEO and the FQHC management team.
Work with Site Leadership Teams (Administrator, Clinic Ops Director, Medical Director and Residency Program Director) to analyze data on charges, denials and revenue.
Design, deploy, and provide ongoing monitoring that addresses provider performance gaps for quality metrics and benchmarks related to value-based care initiatives.
Work with the FQHC Finance Team to provide weekly and monthly financial trending reports.
Remain abreast with all federal, state and departmental coding guidelines and billing procedures.
Attend seminars and/or read publications to increase knowledge and understanding of coding and billing processes as well as to remain up to date regarding reimbursement policies of payers such as Medicare, Medicaid and managed care payers.
Work directly with the Coding Supervisor to review trends in coding and billing related denials, appeal and submission, including tracking findings.
Work directly with the FQHC Finance Office and FQHC sites regarding the roles of financial counselors to insure patients are informed about the FQHC's enabling programs such as sliding fee scales and the 340B medication assistance program and to set up payment plans.
Partner with leadership to ensure process change needs are identified and developed, and that related ongoing training is available.
Direct supervision of Good Faith Estimate staff who provide patients with estimates of visit costs prior to the date of the visit.
Provide training, ongoing mentoring and consultation to department members, providers, and internal staff on applicable policies and procedures.
Work directly with the Patient Business Office to stay updated on current policies and to update the Executive Director on issues relating to the FQHC.
Serve as liaison with the Compliance Office for policy and changes.
Attend department meetings to discuss denial and billing trends and prevention opportunities.
Attend and provide reports to the FQHC Governing Board Meetings.
Maintain active membership in the Illinois Primary Health Care Association and serve on the state-wide Revenue Cycle and Billing and Insurance committees.
Maintain active membership in the National Association of Community Health Centers and attend conferences related to area.
10% Education
Provide education, feedback, and training to coders, providers and departments.
Participate in resident education by providing training at... For full info follow application link.
Southern Illinois University School of Medicine is an Equal Opportunity Employer.
