Reporting to the Vice President for Medical Groups, this position is responsible for the development, implementation, and administration of all policies, procedures and processes to optimize revenue cycle for Medical Groups affiliated with Prime hospitals. This position will work with all medical groups to optimize revenue cycle operations, as well as evaluate whether to in-source or outsource billing operations.

The Director of Medical Group Revenue Cycle with our Prime Healthcare Illinois Medical group will support the following duties and responsibilities:

• Possess expertise in the medical practice billing, collections from patients and third-party payers, accounts receivable and cash management, health insurance including fee-for-service and value-based payments, business office operations, and Health Information Management (HIM)
• Champions revenue cycle improvements throughout the organization including working with appropriate individuals including local Medical Group administrators, Billing Managers, providers, and outsourced vendors.
• Implements and monitors collection procedures, minimizing contractual and bad-debt write-offs, and maximizing cash collections.
• Provides direction and leadership within the reimbursement, coding & compliance, information systems, and credentialing business units.
• Ensures compliance with regulations and billing and collections policies in order to facilitate attainment of accounts receivable (AR) targets.
• Performs ongoing trend analysis on third party payer payment levels to ensure that reimbursement is in accordance with allowable amounts stated in agreements and contracts.
• Prepares financial analysis for use in the third party and managed care negotiation payer process, and works closely with the managed care team to optimize rates and terms.
• Actively monitors and participates in the review and negotiation of third-party payer contracts.
• Establishes and monitors standards for controlling the registration flow as well as the integrity and quality of data throughout the revenue cycle.
• Performs other duties as assigned or required.

Please note: this role is not offerred for remote or hybrid. Will work in-office at our Regional Corp Office located at Resurrection Medical Center. 

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EDUCATION, EXPERIENCE, TRAINING

1. Bachelor’s Degree in Accounting, Health Care Administration, or Business Administration preferred or at least 7 years of relevant experience required.
2. Master’s Degree preferred.
3. Minimum of seven (7) years of healthcare accounting or office management experience, with Five (5) years in management of billing and collections for a physician practice or medical group.
4. Three (3) years supervisory experience required.
5. CPC (Certified Procedural Coder) preferred.
6. Job may require travel to local Medical Groups sites throughout the Chicagoland area as needed. 

Prime Healthcare Illinois Medical Group offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $130,000.00 to $180,000.00 on an annualized basis. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

The company is dedicated to empowering its staff with a comprehensive, competitive benefits package, allowing them the freedom to customize their benefits to fit their unique needs. Our abundant resources, programs, and voluntary options serve as a foundation for individual growth and well-being. Learn more here: https://www.primehealthcare.com/benefitsthatmattermost/