Director of Physician Billing

Transcription

1 Director of Physician Billing Loyola University Health System Maywood, Illinois Position Specification October TradeCenter, Suite 5900, Woburn, MA

2 Summary Loyola University Health System (LUHS), a member of Trinity Health, is seeking a Director of Physician Billing. Reporting to Zack Welch, the Regional Director of Revenue Excellence, the Director will be wholly responsible for leading all activities related to physician billing and oversight of the team. The Chicago Region includes affiliates of the Loyola University Health System (LUHS), including Loyola University Medical Center and Gottlieb Memorial Hospital, as well Mercy Hospital / Medical Center Chicago (Mercy Chicago). This key leadership position will reside at Loyola University Medical Center within the Department of Finance. Total budget for the region is approximately $1.65 Billion with the potential to grow significantly over the next three to five years. The Opportunity The Director of Physician Billing will provide direction and leadership to Central Billing Operations (primarily functions related to claims submission through account resolution) for LUHS professional services. This includes setting priorities, developing policies and procedures, overseeing process design, and financial and human resource management. S/he will also be responsible for the data analysis structure, and measurement techniques to ensure achievement of targeted performance goals which include revenue management performance at industry leading levels. All performance indicators are benchmarked against external survey data. The Organization The people of Loyola promise patients that we go beyond the illness to treat the whole person. Loyola University Health System Mission Statement LUHS is comprised of a comprehensive Academic Medical Center - Loyola University Medical Center (LUMC), Loyola Gottlieb Memorial Hospital, a community hospital located in nearby Melrose Park, and over 30 suburban satellite locations. It boasts the largest NICU in the state of Illinois and has level 1 trauma status. With 775 faculty and 638 residents and fellows, LUHS has a strong tradition of providing high-quality patient care. Grounded in Jesuit traditions, they seek to provide the best patient care through three mission areas: excellence in clinical service, education of tomorrow s healthcare leaders, and research that improves human health in our communities and around the globe. Since 2012, LUHS has been a member of Trinity Health, one of the largest Catholic health care systems and the 12 th largest health system in the United States. Trinity Health was formed in 2000, when Holy Cross Health System merged with Mercy Health Services in a singular mission. In 2011, LUHS selected Larry M. Goldberg as its new President and Chief Executive Officer. Formerly, the Chief Executive Officer at Vanderbilt University Hospital, he brings a plethora of experience to LUHS, most notably as a veteran of academic medicine and strategic business leadership. U.S. News and World Report magazine has ranked Loyola University Hospital as one of the top 50 hospitals nationwide for heart and heart surgery (29 th ). It was also ranked within the top 50 hospitals for 2

3 ear, nose, and throat (43 rd ), urology (44 th ), neurology, and neurosurgery (45 th ). These prestigious honors place Loyola University Hospital among an elite group of hospitals that provide the highest caliber of care for some of the nation s sickest patients. Rankings are based upon reputation, death rates, patient safety, and care related factors. In addition to these nationally ranked programs, LUHS also provides transplant programs for heart, lung, kidney, liver, and bone marrow. Culturally, the organization is committed to excellence, service, and compassionate care giving. Quality and Safety are longstanding top priorities for Trinity Health. In order to fulfill its mission, the leadership fosters an environment that encourages innovation, embraces diversity, respects life, and values human dignity. As part of its core value system, LUHS also treats the human spirit. For more details, please visit Mercy Hospital and Medical Center, a member of Trinity Health, serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities. Mercy Mission Statement Founded in 1852, Mercy holds the privilege of being Chicago s first chartered teaching hospital. Since its founding, Mercy has become an integral part of the city, advancing a mission of providing access to compassionate care to our communities. Today, patients find care that combines world-class medicine with compassion, convenience and an undeniable spirit that sets it apart from other city hospitals. Trinity Health is one of the largest multi-institutional Catholic health care delivery systems in the nation. It serves people and communities in 21 states from coast to coast with 90 hospitals, and 120 continuing care locations that include: home care, hospice, PACE and senior living facilities - that provide nearly 2.1 million visits annually. With annual operating revenues of about $15.9 billion and assets of about $20.4 billion, Trinity Health returns about $1 billion to its communities annually in the form of charity care and other community benefit programs. 3

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6 The Position Scope of the Director of Physician Billing Position: Central Billing Operations Direct billing activities from claims submission through account resolution. Enhances the current billing function by establishing strategic goals and a comprehensive work plan to implement these goals which will enable the organization to achieve industry-leading revenue management performance. This includes the development, implementation and management of standardized billing practices, which are consistent with industry best practices, across and within all payer functional teams. Staffing Works collaboratively with key stakeholders, including hospital patient financial services, to establish staffing levels, productivity targets, and quality measures that meet the performance needs of the organization. Recruits, interviews and selects staff in collaboration with Human Resources and ensures that staffing guidelines/standards are maintained in accordance with PNO Financial and Operational requirements. Performance Improvement Identifies opportunities for operational improvement by comparing current Central Billing Operations performance to industry best practices. Develops action plans, in collaboration with key stakeholders (e.g., physicians, department administrators), to implement change. Identifies and implements opportunities to enhance the collection process to reduce write off's. Actively supports and promotes the Lean journey within areas of responsibility. Reporting and Communication Develops/refines reporting to measure the effectiveness of the revenue management function (e.g., cycle time, denials). Utilizes this data to assist in the communication of revenue management performance with physicians and other key stakeholders. Meets regularly with physicians, PNO leadership and department administrators. Ensures that billing issues (internal and patient identified) are properly investigated, documented and resolved. Prepares ad hoc reporting, as necessary, to investigate billing questions/concerns. Financial Management Assists in the development of annual department budget to ensure appropriate allocation of resources to support operations and meet departmental goals. Manages operational budget including operating expenses and staff levels to meet productivity targets and timelines. Makes recommendations regarding future expenditures in the areas of: additional staffing resources, investment in new technology, enhanced staff education. These recommendations will include ROI estimates or other justifications for expenditure. Team Building Fosters positive team collaboration and staff development to facilitate efficient operations, employee engagement and achievement of patient satisfaction and employee engagement goals. Develops and maintains collaborative relationships with physicians, department administrators, Compliance, revenue 6

7 capture staff and central billing operations staff. Ensures all central billing operations staff develop these same relationships. Professional Development Actively engages in professional development to maintain current skills and knowledge of industry trends, best practices and business opportunities. Ensures an effective training program is developed for staff so that they are proficient, where appropriate, in both IDX/GE and Epic billing system functionality. The Candidate Technical Qualifications & Relevant Experience Bachelor s Degree in Accounting, Finance, Healthcare Administration or a related field. Preference for Masters Prepared or Equivalent in Work Experience. Ten years of job related experience with a minimum of five years operating in a managerial capacity. Experience working in an Academic Medical Center (AMC) setting; understanding the complexities of navigating the various components of an academic program from a physician billing perspective. Expertise building and sustaining relationships with physicians and working collaboratively to engage the physician team, as appropriate into billing, charging and coding practices. Operate independently, be a self-starter and be comfortable making day to day decisions as appropriate. Characteristics of the Candidate The ideal candidate will be a mission driven leader, whose preference is to work within a values based, patient centric provider organization. S/he will be a skilled billings leader whose technical expertise matches their desire to be part of an organization committed to compassionate and healing healthcare within the community they serve. Other personal attributes include: The poise and sophistication to operate in an academic medical center and health systemwide role and promote the important mission and activities of LUHS and Mercy. Being part of a high performing, collaborative team whose shared mission is the provision of measurably world class healthcare. The ability to support and partner with Trinity Home Office leadership, senior management, physician leadership, and peer groups to drive excellence within accounting and all controller led functions. Possessing the personal charisma to motivate and inspire others into action and bringing a can do proactive approach to the arena of finance. A comprehensive understanding of the changing landscape as it relates to healthcare delivery, including new payment models such as accountable care organizations and bundled payment programs and their impact on organizational and financial performance. A high level of Emotional Intelligence. Being highly skilled at building relationships and gaining buy in through engagement, listening, and possessing a transparent communication style. 7

8 The ability to foster an atmosphere of respect, trust, and aligned commitment to organizational goals consistent with the Jesuit mission of LUHS and the Mission and Core Values of Trinity Health. Working collaboratively with peers and others at the LUHS, Mercy Chicago and all affiliated organizations. The ability to manage conflicting priorities and adapt to changing demands in a complex academic setting. Being a skilled facilitator who understands the nuances of serving many masters in a complex and matrixed environment. Critical Success Factors The Director of Physician Billing will: Demonstrate his or her abilities as a relationship person and have the ability to build sustainable relationships across the organization and at all levels. S/he will be comfortable working as part of a team and within a culture that is humble and respectful, but also possess the self-confidence to work alongside a diverse group of people and personalities. Demonstrate his or her success at ensuring a comprehensive Physician Satisfaction Program is in place alongside an increase in physician and employee engagement. Be able to articulate and steer stakeholders through a course of action that results in a positive outcome. Become a respected member of the Finance team and a resource to physician stakeholders. Ensure a comprehensive understanding of physician charging, charge compliance, clinical trials, research studies as well as residents and fellows and be adept at translating the intersection of physician billing to the clinical environment. The Community Loyola University Medical Center and Gottlieb Memorial Hospital are located ten miles west of downtown Chicago. Chicago is renowned for many things; its size (almost 3,000,000 residents), its cultural diversity, which spans almost 100 designated neighborhood areas and its 26 miles of beautiful lakefront. It is estimated that there are over 7,000 restaurants and almost 400 theaters and art galleries combined. As architecturally diverse as it is culturally, it enjoys a national reputation for being a sports town, is famed for its jazz and blues music, and currently boasts some of the most accomplished chefs in the nation. A multicultural city that thrives on the diversity of its neighborhoods, Chicago embodies the values of America s heartland - integrity, hard work, and community that reflects the ideals in the social fabric of its ethnic history. Today, Chicago is a leader in reforming public schools, enhancing public safety and security initiatives that provide affordable housing in attractive and economically sound communities, ensuring accessibility for all, and fostering social, economic and environmental sustainability. Compensation A compensation package will be constructed commensurate with the background and experience of the selected candidate and includes a comprehensive benefits program. Most significant is the opportunity to assume a key leadership role in a thriving organization renowned for its delivery of high quality 8

9 patient care and its compassionate approach to treating the patient in a holistic manner, one that is consistent with Jesuit philosophy and values. For More Information We appreciate all referrals. Interested parties please send resume and cover letter to LUHSDirPhysicianBilling2184@ZurickDavis.com. For additional questions, please contact Fernando Limbo or Annette Cooke at All contact with ZurickDavis will remain confidential. Loyola University Health System, Trinity Health and all affiliates are Equal Opportunity Employers 9