Corporate Director, Billing Optimization
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At a glance
Requirements
Credentials this posting asks for.
Job overview
Prime Healthcare is hiring a Corporate Director, Billing Optimization. The Corporate Director of Billing Optimization leads the strategy, management, and implementation of the Enterprise Billing Program. This role actively owns the portfolio across Revenue Cycle Management, driving optimization and improved metrics across clearing houses. The Director partners with revenue cycle and business office leaders to achieve key performance indicators related to billing operations, including 837 files, billing edits, clean claim rates, and claim rejections. They also lead improvement efforts through strategy development, initiative alignment, and collaboration.
Key focus areas include Lead strategy, management and implementation of the Enterprise Billing Program, Actively own the portfolio across Revenue Cycle Management, and Drive optimization and improved metrics across clearing houses.
Successful candidates bring Bachelor's Degree, 8-10 Years Related Experience, and 5 Years Acute Hospital Revenue Cycle Experience. Important skills include Billing Integrity, Revenue Integrity, Billing Process, Managing Billing For All Payors, Managing Bridge Routines, and Implementing Clearing Houses. Preferred (not required): CHC / Relay Assurance, Meditech, Advanced Knowledge Of Bridge Routine Files, and Writing And Modifying Bridge Routine Files.
Skills & qualifications
Skills
Qualifications
Full job description
Overview
Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0 million patient visits annually. It is one of the nation’s leading health systems with over 60,000 employees and physicians. Twenty-one of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!
If you wish to contribute to the Prime Healthcare legacy as a Director for a hospital within our family of acute care hospitals (or one of our future hospitals), we invite you to join our network to begin exploring immediate and future opportunities.
#AppCast
Responsibilities
The Corporate Director of Billing Optimization is responsible for the strategy, management and implementation of the Enterprise Billing Program, actively owning the portfolio across Revenue Cycle Management and drive optimization and improved metrics across the clearing houses. The Director will partner with revenue cycle and business office leaders across all levels of the organization to execute goals and plans of reach / exceeding key performance indicators (KPI) relating to billing operations, which include but are not limited to: 837 files, billing edits, clean claim rate standards, billing errors and trends, as well as claim rejections and trends. Through strategy development, aligning the annual initiatives and collaboration, the Director will lead improvement efforts through execution of business objectives and strategic initiatives. The Director will provide issue resolution, develop and implement standard operating procedures (SOP) when needed, participate in go-live implementations to ensure successful transition, as well as provide effective communication and stakeholder management at all times. The Director is accountable to the VP of Outsourcing and Strategic Initiatives for timely reports and updates relating to key initiatives, delivering successfully on timelines, as well as effective management of staff and delivery of appropriate productivity and quality parameters if the Director has direct reports.
Qualifications
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Bachelor's degree (B.A.); a minimum of 8-10 years related experience and/or training; or equivalent combination of education and experience.
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Five (5) years of experience with acute hospital/ facility revenue cycle setting.
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Prior working experience within Supervisory/ Management capacity, specifically with Billing Integrity, Revenue Integrity, and Billing Process, includes managing the billing for all payors, includes managing bridge routines.
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Prior experience in implementing clearing houses and preferably rollout of EPIC program in a large hospital setting.
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Ability to envision and execute; process and policy changes, change in corporate culture, alignment between enterprise strategy and individual business channel needs.
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Proven ability to effectively interact with key stakeholders, hospital leadership and other team members, while maintaining standard of professional business service
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Strong communication and relationship management skills.
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Ability to form collaborative working relationships.
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Strong analytical and problem-solving skills. Ability to review weekly, monthly metrics – leading and lagging KPIs and own action plans. Proven ability to make logical correlations between data points to determine if analysis is accurate.
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Ability to envision and execute; process and policy changes, change in corporate culture, alignment between enterprise strategy and individual business channel needs.
Preferred qualifications:
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Proficiency with IT hospital revenue cycle tools like CHC / Relay Assurance (also known as ePremis, now part of Optum), EPIC, Meditech.
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Advanced knowledge and management of bridge routine files – writing and modifying, CCI edits, 835, EFT, ERA, and claim error trends across multiple payor base and across states.
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Meditech and EPIC: basic navigation of systems as a minimum.
Employment Status
Full Time
Shift
Days
Equal Employment Opportunity
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC\_KnowYourRights\_screen\_reader\_10\_20.pdf
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ID2026-248696
CategoryDirector
Position TypeFull Time
ShiftDays
Job TypeExempt
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