The Senior Director of Hospital Billing and Outpatient Coding is responsible for strategic activities as it relates to the mid-cycle and back-end patient-related revenue cycle activities for OHSU Health which includes OHSU and all of OHSU system partners both current and future.

• The operational functions under this position's oversight include direction over diagnosis coding and abstracting all outpatient facility accounts, inputting charges, combined customer service, billing to all third parties, follow up with those third parties to ensure payments are received in a timely manner, denial management, payment review, cash posting and credit balance analysis and resolution, referral to bad debt and the overall operational effectiveness of Hospital Billing and Coding. This position will focus on revenue cycle operational performance excellence across the system and improving the patient experience with a focus on cost containment.
• The Senior Director oversees and is responsible for the Epic systems build including claims maintenance and the development of Epic and operational revenue cycle workflows.
• The Senior Director oversees and is responsible for the Huron system and partnerships as related to the back-end revenue cycle.
• The Senior Director will respond proactively to maximize revenue opportunities related to revenue cycle through third party partners and through automation of more efficient workflows. Responsibilities will include creating the best practices in each of the revenue cycle areas above that can be shared and implemented across the system affiliates.
• Critical responsibilities include the achievement of annual and periodic goals for significant statistical indicators of revenue cycle performance that contribute to the financial performance of OHSU and OHSU Health partners.
• The Senior Director will work collaboratively with internal partners in Hospital Financial Services, HIS, Care Management, clinical and ancillary departments and senior leadership to assure compliance with hospital coding, billing and reimbursement.
• This position reports to the Vice President of Enterprise Revenue Cycle for OHSU Health and has oversite responsibility for the staff and duties related to the functions described above, as well as directing strategic initiatives and enterprise wide performance improvement initiatives, to ensure smooth revenue cycle operations that meet the patient care and financial needs of OHSU and OHSU Health partners in a way that demonstrates compassion and service to our patients and their families.

• Leads and directs the Hospital Billing and Coding Revenue Cycle team. Works with leadership across the system to carry out comprehensive, integrated planning for all areas of responsibility with emphasis on strategic initiatives, patient centered processes and continual process improvement. 

  • Develop strategic plans that are compatible with the OHSU Health's mission, goals and objectives.

  • Establish and coordinate procedures for timely coding, billing, posting and collection of accounts to assure positive cash flow and effective management of credit balances. Provide administrative directions to the management staff.

  • Establish expectations and plans, set priorities, and manage processes to measure, assess, and implement improvements to services provided. Measure, monitor and report progress towards quality goals on a routine basis. 

  • Synthesize qualitative and quantitative information and identify trends to keep the cash flow on course. 

  • Monitor un-billed reports and work with departments (PAS, ITG, and Care Management) to resolve issues in a timely manner so not to delay billing functions. 

  • Communicate with third party payors in regard to claim processing difficulties or new processing procedures. 

  • Participate in OHSU and OHSU Health partners system wide front end, mid-cycle and back-end revenue cycle, denial management and access management work teams. 

  • Maintain a working knowledge of applicable National, State, and local laws and regulations, the hospital Compliance Program, Code of Ethics as well as other policies and procedures. 

  • Participate in Revenue Cycle projects as directed by Vice President of Enterprise Revenue Cycle. 

  • Assist Revenue Cycle Team in staffing, managing, documenting, and completing assigned projects. 

  • Ensure all assigned department performance appraisals are completed on time.

• Responsible for appropriate staffing of OHSU Health Hospital Billing and Coding positions, performance evaluations and recommendation for promotions, counseling and disciplinary action. Demonstrate ability to initiate planned change in department, due to change in workload, schedules, or emergency situations that would require reallocation of staff. 
  • Provide orientation and training to staff to improve skills and performance.
  • Facilitate innovation and motivate staff to effectively attain operational and patient satisfaction goals
  • Coach staff (represented and management) on technical, operation, and team behavior issues; champion excellence, the customer and collaborative team behavior.

• Create, monitor and maintain a positive patient experience.

  • Utilize HFMA Patient Friendly Billing resources to create a consistent and positive revenue cycle patient experience throughout the OHSU system.

  • Meet with patient focus groups to understand issues and concerns from a patient perspective. Communicate these issues and concerns to OHSU leadership and work with revenue cycle areas to implement best practice changes to provide a better patient experience.

  • Create, monitor and maintain revenue cycle patient experience surveys. Communicate survey results to OHSU Health leadership and work with revenue cycle teams to implement possible changes to provide a better patient experience.

• Effectively communicate with superiors, peers, subordinates, and others, as appropriate, on a regular basis, assuring proper flow of information.

  • Maintain a direct and open line of communication with Administration through the Vice President of Enterprise Revenue Cycle by providing relevant information on matters requiring department administrative action.

  • Resolve physician, patient, clinician, and interdepartmental complaints and misunderstandings

• Responsible for the departmental budget.

  • Gather feedback from appropriate staff in the development of the budget(S).

  • Consistently operate within budgetary goals in areas of labor and other operating expenses.

  • Prepare monthly analysis of actual expenses as compared to budget. 

  • Communicate explanation of significant variances to Vice Present of Enterprise Revenue Cycle each month which includes but is not limited to plans on staffing, staff development, and productivity improvements.

  • Regularly provide productivity updates and reallocate resources as necessary to reduce financial risk and enhance patient experience.

Education:

• Bachelor degree in Business or related field, or equivalent combination of education and experience

Experience:

• Minimum of ten years’ experience in revenue cycle operations
• A minimum of five years’ experience leading a revenue cycle/billing department in a health system or major hospital.
• Demonstrated knowledge of all phases of patient accounting, operations, issues, challenges and performance metrics. 
• Demonstrated record of accomplishment in meeting performance hurdles for improving gross revenue, cash collections as well as hitting targets for net days in accounts receivable. 
• Record of performance in developing and sustaining performance accountability at all levels within the revenue cycle operations department.
• Record of effective collaboration with other members of the revenue cycle team to ensure success in achieving hospital or system performance targets. 
• Track record for successfully making and effectively implementing tough decisions.

Job Related Knowledge, Skills and Abilities (Competencies):

• Exceptional leadership skills with a record of building a strong, results-oriented team that excels in a performance-driven environment.
• To provide leadership that will achieve and sustain performance momentum. 
• A recognized problem-solver with a history of building a best-in-class department.
• Executive presence with a sense of urgency with performance and process improvement. 
• Reputation for attention to details and meeting deadlines with a superior work product. 
• Intellectual capacity to assess complicated processes and to devise creative solutions that will enhance performance.
• Demonstrated consistent commitment to effective customer service. 
• Effective written and verbal communications skills
• Ability to work in a self-directed manner 
• Demonstrated skills in effectively managing political issues and situations. 
• Demonstrated record of accomplishment in recruiting, retaining and developing managers and staff members.

• HFMA, CHFP or HFMA FHFMA
• Masters of Healthcare Administration preferred
• Seven years of progressive supervisory, management and leadership in a health system or major hospital. 
• Demonstrated knowledge of dealing with potentially complex managed care contracting issues with a record of success in effectively producing appropriate patient bills consistent with the contract

• Standing: As required to make presentations or perform other job tasks.

• Sitting: Chair or stool continuous up to 8 hours per day able to intermittently move about

• Changing Position: Intermittently, as needed from sitting to standing to walking, etc..

• Walking: Intermittently 2 - 4 hours per day on concrete, vinyl, and carpeting.

• Carrying: Up to 25 pounds (supplies, equipment, books, papers, etc) for intermittent periods and distances.

• Lifting: Up to 25 pounds ( equipment, supplies, books, etci.) ntermittent throughout the week.

• Pushing/Pulling: Up to 25 pounds, intermittent, monthly 

• Bending: From the waist and knees, frequently throughout the day.
• Reaching/Handling: Fine manipulation, repetitive, gross motor requiring reasonable ROM in upper extremeties, including overhead reaching. 
• Twisting: Reasonable ROM required, intermittent periods, throughout the day.
• Climbing: Staircase, intermittently throughout the day. 
• Crawling: Infrequent but possible on vinyl, carpet surface to retrieve or attend to articles that require attention.
• Hearing: sufficient to conduct business via telephone and in-person. 
• Speech: speak English to various individuals and audiences, efficiently, understandably and courteously. · Other as expected in a normal office setting

Oregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request reasonable accommodation contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or aaeo@ohsu.edu.