At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates.

Job Summary

The Revenue Cycle Operations AVP is a member of the revenue cycle leadership team and is directly responsible for overseeing Scion Health’s day-to-day operations of the Centralized Business Office (CBO) operations, ensuring efficient and effective business practices and fostering a productive and positive work environment. This position works with the current CBO leadership to drive key performance indicator outcomes with department heads to determine the need for action from leadership and/or management such as re-education or revisions related to the facility’s financial outcomes. The AVP will be pivotal in harnessing data to establish, manage, and refine performance goals, ensuring these goals align with the company's strategic growth objectives. We are looking for a candidate with a robust management background, capable of driving team performance through effective communication, leadership, and a relentless pursuit of excellence. 

Essential Functions 

• Develops, leads and improves Scion Health’s CBO workforce, processes, and technologies to ensure they are developing, building and improving. 
• Work with all business office partners in the short term and long-term care facilities with overlapping responsibilities to provide guidance in the physician space. 
• Analyzes historical data, market trends, and payer reimbursement patterns to project future revenue, enabling strategic planning and decision-making to enhance fiscal stability and growth. Leads and or coordinates efforts to reduce denials, eliminate waste, and improve service experience. 
• Oversees the development and enforcement of policies and procedures that comply with healthcare regulations, ensuring a robust compliance and risk management framework. 
• Promotes a culture of continuous improvement and innovation within the CBO operations to adapt to changing healthcare landscapes. 
• Guides and mentors revenue cycle team members, fostering a collaborative environment that attracts and retains top talent. 
• Identify and troubleshoot AR issues by analyzing denials, open AR and payer feedback. 
• Demonstrate strong organizational skills, including attention to all detail for the full scope of all aspects of daily team functions. 
• Address concerns and conflicts with coworkers and team members in a constructive manner. Problem solves with team members and remove barriers to help improve work processes. 
• Cooperate with other departments in pursuing opportunities for improvement. 
• Assist leadership in the development, implementation and analysis of protocols, standards/work methodology and policies to remain consistent with industry trends and company objectives. 
• Monitor payor performance and outcomes for efficient account resolution. Engage in researching payer websites/payer policies and other reputable online resources to assist as needed with claim/account resolution. 
• Recommend strategies to improve outcomes and processes. 
• Collaborate with leadership on cost saving initiatives. 

Knowledge/Skills/Abilities/Expectations

• Strong leadership skills with the ability to motivate a team in a fast-paced evolving environment. 
• Strong analytical and technical skills. 
• Ability to complete work independently and prioritize work, this includes working in a team environment. 
• Possess an understanding of HIPAA as it relates to Personal Health Information (PHI). 
• Basic Knowledge of general accounting principles and standards. 
• Basic Knowledge of ICD-10 and CPT guidelines in accordance with federal and payer guidelines, includes use of modifiers, NCCI edits, CMS LCD (Local Coverage Determination and CMS Articles. 
• Knowledge of insurance reimbursement practices and overall/general through understanding of revenue cycle management (RCM) 
• Basic understanding of medical terminology and experience in various reimbursement/billing methodologies. 
• Intermediate skills in Microsoft Office (Word, Excel.) 
• Excellent communication and problem-solving skills, as well as sound judgment

Experience

• A minimum of 10 years’ experience of hospital billing, cash posting, AR collections and follow up experience is required. 
• With progressive leadership experience within a hospital business office. 
• In addition, knowledge through hands-on experience in billing, collections, denials, payment posting, Patient Accounting systems, clearinghouses/claim submissions and rejections and an overall knowledge of insurance portals, is needed.