The Director A/R Operations is responsible for the operation of the professional fee billing office for Johns Hopkins University Department of Radiology, Bayview Radiology Physicians, and Radiologist activity at Sibley and Suburban Hospitals. This position is also responsible to the CPA and will serve in a Sr. Production Unit Manager capacity when setting standards and monitoring and reporting results. This role will also be responsible for the global billing of four freestanding sites currently operated by Johns Hopkins Imaging LLC for Radiology to ensure that both the technical and professional billing is correct and within in the guidelines of the HSCRC.
This role serves as the Departmental Compliance Liaison for the University and has oversight of the Manager responsible for Research and Technical billing. In addition, this position will provide critical support and take a lead role related to managing on-going acquisitions for Johns Hopkins Imaging LLC.
This position reports directly to the Administrator and Sr. Director, Core Services. Although there is not a direct reporting relationship, there are frequent critical interactions with the Department Chair and Division Chiefs.
This position will supervise: 25 Full time employees 3 Managers 2 Supervisor 3 Lead Positions 27 Staff Positions
The responsibilities of this position are detailed below.
Manages the following daily activities:
Timely collection of registration and charge data.
Inventory control of charge batches.
Batching, coding, and entering of charge data on a timely basis.
Masters and educates staff on the proper coding of complex and multiple procedures across the sections of the Department of Radiology that may require full understanding of multiple modifiers and other code modifications over several hundred payers.
Responsible for the development of billing policies and procedures for the Department's professional fee billing office consistent and complementary to those already developed by the Physicians Billing Service.
Serves as the key financial contact for Radiologist leadership at the monthly Practice Management and Compliance Meeting.
Stays up-to-date on changes in insurance requirements of several hundred payers for the Department of Radiology and ensures that the office procedures meet these requirements required to ensure prompt payment.
Establishes and maintains a superior rapport with Department Director and Administrator.
Builds relationships with and meets quarterly with each of 10 Division and Section Chiefs, physicians, and managers to answer billing related questions and help them to better understand the various billing related issues, especially E&M coding, reporting errors, and eliminating compliance risks.
Researches and resolves problems as needed.
Provides ongoing education to the Department's registration and technical staff's to assure data entry is timely, accurate, and compliant to optimize the collections process.
Report missing or incorrect charges to Divisions or areas responsible for generating charges.
Interface with third-party professional relations representatives regarding billing issues.
Maintain a good working knowledge of all third-party billing policies and procedures.
Oversees reconciliation and logging of all charge batches.
Establishes and implements mechanisms for bi-directional daily reconciliation of JHU professional charges and JHH technical fee charges (totaling ~$200,000,000), and identifying and correcting omissions in both systems.
Implements technical and operational changes with JHU, JHImaging LLC, and JHH staff to prevent/eliminate these errors.
Monitors performance to assure they do not reoccur.
Works with both physician and technical staffs to maintain the Department's Charge Description Master to assure accurate and compliant billing practices.
Identifies and measures accuracy of the Department's electronic charge capture and billing information systems.
Makes recommendations for revisions and remedies to the Department's and CPA's information system teams.
Periodically review batched charges to ensure proper coding.
Reviews monthly Service Analysis Reports to ensure appropriate use of all billing areas, locations, financial classes, etc.
Assures weekly billings meet budgeted projections and implements corrective plan if projections are not met.
Interface with CPA Revenue Operations Director and appropriate CPA personnel to coordinate all billing office procedures. Works with the Physicians Billing Service, the Medical Service Plan, the Department, Insurers, and others to ensure that the operations adequately serve the needs of patient identification, demographic information collections, insurance information, referring physician identification, referral management, proper coding, etc.
Approve and supervise all account corrections/transactions.
Executes discounts when authorized by the Chair or Administrator.
Establishes and maintains controls for "Payment at Time of Service." Program.
Review and make recommendations regarding third-party coding of new procedures.
Perform random audits monthly to ensure all charges are billed as requested by Division Managers.
Review need for tracking billings and collections and implement mechanisms to do so, as necessary, with Production Unit Manager.
Attend all CPA operations, quarterly Division, Section Chiefs, and monthly Compliance meetings.
Ensure that all services rendered in a given accounting period (with the exception of inpatient services) are billed during that period.
Attends and participates in various committees, meetings, and other forums as needed to stay informed of organizational initiatives that impact the billing office, and represents the Department's interests as needed.
Implement new procedures to allow for appropriate billing of all charges.
Generate and maintain procedures and policies relative to functional areas.
Performs all other duties as assigned.
Serves as the day-to-day liaison with American Radiology Services, monitoring both JHU payments to them for billing services and ARS payments to JHU for services performed by JHU physicians at ARS site.
Completes the following Monthly Reports:
Clinical Practice and Accounts Receivable Analysis
Practice Financial Summary
Outside Read report
Billing area/physician reports
Key components of the monthly Practice Management Dashboard
Represents the department for all University Billing and Collection Compliance matters.
Responsible for keeping all compliance records current and easily accessible to the Department.
Annual review of the department compliance plan to ensure that any updates or changes are recorded and submitted to compliance.
Completion and submission of the quarterly compliance report.
Completion and submission of a monthly audit of the outpatient consults.
Monthly Compliance meeting.
Quarterly Physician audits and meetings with the Chairman, Directors, and Administrator.
Annual review and update of the Radiology requisitions.
Annual review of CPT and ICD-10 coding.
Serve as a contact person for the Hospital and University auditors.
Responsible for reviewing and correcting the ICD-10 coding rejected on the technical bill.
Update annually the charge master and RIS the new CPT codes (to be completed prior to January 1st of each year).
Purchase the new ICD-10 disc so radiology IT can download into the RIS. These codes are effective October 1st of each year).
Bachelor's degree required.
Minimum of seven (7) years of professional fee operations management experience.
Additional experience may substitute for some education, and additional education may substitute for some experience, to the extent permitted by the JHU equivalency formula.
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.
Master's degree is preferred.
In-depth knowledge of academic Department of Radiology-specific billing issues and experience in a management position in an academic Department of Radiology professional fee billing office is highly desired.
Johns Hopkins University remains committed to its founding principle, that education for all students should be grounded in exploration and discovery. Hopkins students are challenged not just to learn but also to advance learning itself. Critical thinking, problem solving, creativity, and entrepreneurship are all encouraged and nourished in this unique educational environment. After more than 130... years, Johns Hopkins remains a world leader in both teaching and research. Faculty members and their research colleagues at the university's Applied Physics Laboratory have each year since 1979 won Johns Hopkins more federal research and development funding than any other university. The university has nine academic divisions and campuses throughout the Baltimore-Washington area. The Krieger School of Arts and Sciences, the Whiting School of Engineering, the School of Education and the Carey Business School are based at the Homewood campus in northern Baltimore. The schools of Medicine, Public Health, and Nursing share a campus in east Baltimore with The Johns Hopkins Hospital. The Peabody Institute, a leading professional school of music, is located on Mount Vernon Place in downtown Baltimore. The Paul H. Nitze School of Advanced International Studies is located in Washington's Dupont Circle area.