Career Center
El Cajon, California
Northridge, California
El Cajon, California
Oakbrook Terrace, Illinois
Posted: 04-May-23
Location: Middle River, Maryland
Salary: Open
Internal Number: 109000-en_US
We are seeking a Director of Accounts Receivable. This position directly manages professional fee operations for the DOM to assure timely and consistent reimbursement for services provided by 700+ providers (across 17 clinical divisions) with charges of $340+ million per annum. Additionally, this position manages and directs a DOM internal compliance team that partners with the School of Medicine compliance office to research and mitigate compliance risk. This position interprets DOM key performance indicators (KPI's) to clarify performance achievements and identify areas requiring intervention to DOM Leadership, Divisional Leadership, Faculty, and Clinical Practice Association.
Specific Duties & Responsibilities
Physician's Billing Services (JHCP)
- This position oversees and directs the coordination of functional activities of five JHCP Divisions encompassing 600 physicians with charges of $300 million per annum.
- Additionally this position oversees the development, implementation, and refinement of policies and procedures for the CPA's JHCP Physicians Billing Service.
- This position assists the Senior Director of Client Services – Medical Specialties in the form of analysis, consultation, planning, and management of the financial and administrative operations of the CPA's JHCP billing service and acts in a liaison capacity with the Chief Financial Officer of JHCP regarding the billing and collection of JHCP charges.
- The position also acts as point with JHCP on resolution of billing issues and matters relating to Epic billing structures.
Department of Medicine JHH (DOM)
- This position directly oversees hospital fee operations for the DOM to assure timely and consistent reimbursement for services rendered, including multiple divisional administrations, with charges of ~$150m for hospital-based procedure services.
- Additionally, this position integrates with a DOM internal compliance team, partnering with the School of Medicine and JHH compliance offices to research and mitigate compliance risk.
- With the advent of the EPIC system, this position will also work with the DOM Director of Finance, SOM DOM Billing to identify opportunities to streamline and where possible, integrate efforts by both JHH and JHU teams to minimize duplication of efforts.
Department of Medicine – John Hopkins University
- Evaluates and informs Vice Chair of Clinical Affairs and Administrator(s) on issues regarding reimbursement, documentation, and professional fee billing related to the role of the attending physician, fellow, resident, or advanced practice provider. Presents recommendations and guidance for resolution when applicable.
- In cooperation with the Administrator(s) and Director of Finance, analyzes practice professional fee revenue results and trends, billing volume statistics, other billing KPIs, and cost of collections..
- Develops management reports to evaluate productivity, quality, and efficiency of billing office staff. Designs implementation plans to improve and maintain productivity, quality and efficiency. Maintains positive employee relations climate.
- Monitors financial results of clinical practice and advises Vice Chair of Clinical Affairs, Administrator(s), Director of Finance and applicable division leadership teams on concerns or opportunities to improve revenue generation/capture. Partners with the Director of Finance and division administrators to understand revenue variances (budget and year-over-year changes).
- Develops and implements standardized administrative and operational procedures including such written policies and procedures as required.
- Establishes and maintains working relationships with third party payers (Blue Shield, Medicare, HMOs, etc.) to ensure timely billing and accurate processing of claims and reimbursements.
- Reviews and updates multiple fee schedules on a semi-annual basis. Monitors reimbursement levels and adjusts charges to minimize missed reimbursement opportunities.
- Assures appropriate credentialing activities as they pertain to physician billing status and provider enrollment requirements (3rd party billing).
- Acts as liaison for the Department with CPA services, establishing plans to achieve and maintain benchmark billing performance.
- As needed, establishes informational databases and systems to allocate, track, monitor and report on professional fee revenues. This includes design, implementation and analysis of exception reporting mechanisms to assure timely intervention when necessary to maintain fiscal integrity with staff productivity, CPA performance and clinical practice performance.
- Prepares financial analysis and ad-hoc reports requested by department leaders, faculty, CPA leadership and others.
- Assists in the coordination of Department and SOM initiatives involving managed care relationships to include enrollment, medical record attestation, contracts, etc.
- Develops and analyzes data to support managed care, global pricing and other initiatives.
- Educates and/or oversees the education of billing personnel, providers and division leadership team in correct use and application of both CPT and ICD coding, charge entry-billing procedures, and follow-up policies and procedures.
- Manages internal Compliance team that partners with the University Compliance Office to coordinate audit efforts by third party carriers.
- Keeps abreast of potential regulatory changes (e.g., annual CPT updates, annual CMS reimbursement changes, coding/documentation changes, etc.) that impact professional fee reimbursement revenue. In cooperation with the Office of Billing Quality Assurance, prepares and implements communication plan to inform and educate department and divisional leadership. Identifies areas of risk related to regulatory changes and proactively communicates to departmental and divisional leadership teams.
- Monitors and re-evaluates A/R priorities for Medicine on a monthly basis. Develops and analyzes reporting tools to optimize collection strategies.
Physician's Billing Services, JHCP Medicine
- Oversees and directs the coordination of functional activities of assigned JHCP Divisions including coding, charge entry, insurance follow-up, appeal functions, refunds, and Patient Inquire Data Base.
- Oversees the development, implementation, and refinement of billing policies and procedures relative to the CPA's JHCP billing service.
- Acts as the liaison with the JHCP CFO regarding the activities of the CPA's billing office in regards to JHCP's billing and collection status, including receivables, collections and denial activities and performance relative to benchmarks.
- Provides assistance to the JHCP CFO in the form of data analysis, consultation, planning and management of the financial and administrative operations of the CPA's JHCP billing service.
- Establishes and maintains working relationships with third party payers (Blue Shield, Medicare, HMOs, etc.) to ensure timely billing and accurate processing of claims and reimbursements.
- Reviews and updates multiple fee schedules on an as needed basis. Monitors reimbursement levels and adjusts charges to minimize missed reimbursement opportunities.
- Analyzes the CPA's JHCP billing operations performance standards and develops and implements productivity measurements.
- Develops reports, analyzes data, and provides financial information to assigned department administrators and relative to billing and collections activities.
- Monitors and re-evaluates A/R priorities for JHCP on a monthly basis. Develops and analyzes reporting tools to optimize collection strategies.
- Responsible for communicating the goals of the CPA to the JHCP assigned divisions and oversees the development of processes to facilitate those goals.
- Responsible for revision and refinement of billing operations policies and procedures to accommodate the needs of the CPA JHCP divisions.
- Provides operational information of assigned JHCP divisions to the JHCP CFO and monitors actual charge/payment activities relative to budgeted charges and payments for those assigned departments.
- Assists in the development of departmental revenue budgets.
- Assists in the development of the JHCP expense budget and monitors expense activities for JHCP functions.
- Coordinates assigned divisional training activities as they relate to EPIC.
- Participate in the Revenue Recovery Operations Committee.
- Provide oversight of day-to-day billing operations for designated JHCP Divisions
- Continually identify opportunities for process improvement targeting problem areas and identifying corrective actions to ensure staff work effectively as a team.
- Ensure billing manuals and specific billing instructions have been created with ongoing updates.
- Keeps continually abreast of potential pending regulatory changes that might impact professional fee reimbursement revenue.
Department of Medicine – John Hopkins Hospital
- Oversee Business Owner for JHH E.B. campus MUSE system. Ensures all charges route appropriately to both H.B. and P.B. modules. Works closely with EPIC interface teams to monitor data flow. Develops and maintains working relationship with G.E. Application and Technical support.
- Develops and monitor interface reconciliation protocols for all third-party systems that generate and transfer charges to EPIC. Alerts appropriate departmental personnel of any interface issues that could affect timely charging. Examples include:
- Cardiology – MUSE, Med Stream, and Synapse
- Gastroenterology - Pentax and Olympus
- Nephrology - Falcon
- Pulmonary - Compass
- Represents DOM in the JHH revenue improvement related to the Revenue Cycle / Denial Management projects. Work to identify trends and sources of denials. Develop and implements processes to mitigate financial impact.
- Prepare financial analysis and special reports as required by departmental leaders, faculty, CPA leadership and others.
- Continually identify opportunities for process improvement targeting problem areas and identifying corrective actions to ensure staff work effectively as a team.
- Ensure billing manuals and specific billing instructions have been created with ongoing updates.
Special Knowledge, Skills & Abilities
- Knowledge of accounting and budgeting theory and practices.
- Specific knowledge of internal medicine specialties preferred. Must possess strong interpersonal skills including strong negotiation skills, strong written and oral communication skills and ability to work collaboratively.
- Must possess ability to exercise a high degree of initiative, judgment, discretion and decision making to achieve organizational objectives.
- Ability to work with flexibility on several tasks simultaneously and to meet various concurrent deadlines.
- Very strong organizational skills, analytical and problem solving abilities, and attention to detail.
- Oversee and prioritize/coordinate the work of others.
- Ability to maintain confidentiality.
Minimum Qualifications
- Bachelor's Degree in Health Care Administration, business or related discipline.
- Minimum of ten years professional fee billing or similar medical billing experience.
- Three years supervisory or lead experience required.
- Additional experience may substitute for education to the extent permitted by the JHU equivalency formula.
Preferred Qualifications
- Minimum of five years of professional fee accounts receivable management experience.
- Proficiency in EPIC.
- CPC certification.
- Knowledge of JHM and JHU/ PBS billing application
Classified Title: Director A/R Operations
Working Title: Director of Accounts Receivable
Role/Level/Range: L/04/LF
Starting Salary Range: $95,370- $131,100- $166,850 (Commensurate with experience)
Employee group: Full Time
Schedule: M-F: 8:30-5:00
Exempt Status: Exempt
Location: Hybrid/JH at Middle River
Department name: SOM DOM Billing
Personnel area: School of Medicine
Total Rewards
The referenced salary range is based on Johns Hopkins University's good faith belief at the time of posting. Actual compensation may vary based on factors such as geographic location, work experience, market conditions, education/training and skill level. Johns Hopkins offers a total rewards package that supports our employees' health, life, career and retirement. More information can be found here: https://hr.jhu.edu/benefits-worklife/
Please refer to the job description above to see which forms of equivalency are permitted for this position. If permitted, equivalencies will follow these guidelines:
JHU Equivalency Formula: 30 undergraduate degree credits (semester hours) or 18 graduate degree credits may substitute for one year of experience. Additional related experience may substitute for required education on the same basis. For jobs where equivalency is permitted, up to two years of non-related college course work may be applied towards the total minimum education/experience required for the respective job.
**Applicants who do not meet the posted requirements but are completing their final academic semester/quarter will be considered eligible for employment and may be asked to provide additional information confirming their academic completion date.
The successful candidate(s) for this position will be subject to a pre-employment background check. Johns Hopkins is committed to hiring individuals with a justice-involved background, consistent with applicable policies and current practice. A prior criminal history does not automatically preclude candidates from employment at Johns Hopkins University. In accordance with applicable law, the university will review, on an individual basis, the date of a candidate's conviction, the nature of the conviction and how the conviction relates to an essential job-related qualification or function.
The Johns Hopkins University values diversity, equity and inclusion and advances these through our key strategic framework, the JHU Roadmap on Diversity and Inclusion.
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All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
EEO is the Law
Learn more:
https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf
Accommodation Information
If you are interested in applying for employment with The Johns Hopkins University and require special assistance or accommodation during any part of the pre-employment process, please contact the Talent Acquisition Office at jhurecruitment@jhu.edu. For TTY users, call via Maryland Relay or dial 711. For more information about workplace accommodations or accessibility at Johns Hopkins University, please visit accessibility.jhu.edu.
Johns Hopkins has mandated COVID-19 and influenza vaccines, as applicable. Exceptions to the COVID and flu vaccine requirements may be provided to individuals for religious beliefs or medical reasons. Requests for an exception must be submitted to the JHU vaccination registry. For additional information, applicants for SOM positions should visit https://www.hopkinsmedicine.org/coronavirus/covid-19-vaccine/ and all other JHU applicants should visit https://covidinfo.jhu.edu/health-safety/covid-vaccination-information/.
The following additional provisions may apply, depending on campus. Your recruiter will advise accordingly.
The pre-employment physical for positions in clinical areas, laboratories, working with research subjects, or involving community contact requires documentation of immune status against Rubella (German measles), Rubeola (Measles), Mumps, Varicella (chickenpox), Hepatitis B and documentation of having received the Tdap (Tetanus, diphtheria, pertussis) vaccination. This may include documentation of having two (2) MMR vaccines; two (2) Varicella vaccines; or antibody status to these diseases from laboratory testing. Blood tests for immunities to these diseases are ordinarily included in the pre-employment physical exam except for those employees who provide results of blood tests or immunization documentation from their own health care providers. Any vaccinations required for these diseases will be given at no cost in our Occupational Health office.
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