JWM Neurology
JOB TITLE: Chief Financial Officer / Chief Information Officer
GENERAL SUMMARY OF DUTIES: Revenue Cycle; Information Systems; Compliance; Credentialing; Analysis & Financial Reporting
SUPERVISION BY: Reports to the Executive Director
SUPERVISES: Data Informatics and Revenue Cycle Manager; Business Office Manager; Credentialing Coordinator
ESSENTIAL FUNCTIONS:
1. Revenue Cycle
§ Directs all business office functions to ensure accurate and timely billing and collection of revenues for all services provided by practice.
§ Coordinates with COO
o To insure all front-end data collection is accurate
o Pre-certs/Pre-determination are timely and accurate
o Registration information is captured and communicated to Business Office
o Communication between Business Office and Clinics is timely and collegial
§ Directs Business Office Manager to insure
o Charge entry is accurate and timely
o Billing is accurate and timely
o Denials are worked and resolved quickly and timely
o Missing Ticket report is reconciled timely
o Payer issues are recognized and guidance is given to resolve
o Self-pay collections are managed and Collection Agency referrals are done within policy
o Establish and maintain relationships with outside collection agencies and vendors and monitor their collection rates
§ Directs Data Informatics Manager to insure
o Coding audits are consistent and timely
o Identify coding abnormalities or trends that require provider and/or staff training and completes said training
o Identifies denial trends and works with appropriate individuals to appeal and develop workflows to prevent future instances
o Manages Revenue Cycle Committee and prepares reports to review monthly activities/trends. These reports include:
v A/R Days and A/R Trends
v Business Office Staffing
v Write-off Trends and Analysis
v Days to Post/Bill
v Denials Management
v Provider Charge Turn-in Issues
v Payer Trends and Issues
o Chairs the Denial Committee to identify trends, prepare education for appropriate staff, coordinate with managers on workflows to prevent future denials.
- § Directs Credentialing Coordinator to insure
- o New providers are credentialed with appropriate hospitals on a timely basis
- o New providers are credentialed with all payers as needed
- o Credentialing database is kept current
- o All JWM Providers credentialing status is kept current with all hospitals and payers
- o Coordinates with providers so they keep their CMEs up to date to meet local hospital requirements
- o Communicates with Medical Malpractice Company (MedPro) to insure coverage is current and maintained at required levels
§ Maintains knowledge of governmental, insurance, and third party procedures and regulations as well as review all available resources to stay abreast of payer trends. Communicates timely any changes or trends in the above information that will materially affect the practice operations or financial performance.
o Maintain relationships with Third Party payers
o Review and recommend approval of Third Party contracts
2. Information Systems
§ Directs the activities of the Information Systems vendor which includes
o Local support
o Help Desk support
o Engineering support
o Updates of software and hardware
o Manage costs within reasonable expectations
§ Directs the activities of the Phone Systems vendor which includes
o Local support
o Help Desk support
o Engineering support
o Updates of software and hardware
o Manage costs within reasonable expectations
§ Recommends and implements use of technology to improve quality and quantity of work produced
§ Maintains and Supports all users related to EHR
o Helps providers with template management
o Provides support to all super-users when needed
o Updates fee schedules, vocabulary reconciliation, orders/order sets, and other tables as needed
o Provides user set up and password resets when needed
o Insures practice implements updates as appropriate
o Acts as primary liaison with Greenway C-Level personnel and other key individuals
3. Compliance
· Participate on the JWM Compliance Committee as the Compliance Security Officer
· Give general input related to all compliance issues
o Stark and Anti-Kickback
o Billing issues
o HIPAA Privacy
o Breaches
· Plan required annual compliance processes related to HIPAA Security
o Protect the Confidentiality, Integrity, and Availability of ePHI
o Perform Risk Assessments and Security Audits
o Coordinates with IT Vendor to recommend and manage hardware and software to provide security of IT system and databases
o Staff Training
· Ensures systems and workflows are in place to meet Federal and State requirements for
o Good Faith Estimates
o EPCS
o Telehealth
o No Surprise Act
o Indiana Death Registry
o Others as required/needed
4. Analysis and Financial
· Prepare various reports on a Monthly and Annual basis
o MOJE
o FTE / Staffing Reports
o RVU Reports
o Annual Open Payment analysis (Sunshine Act)
o Other analysis as requested
o Presentations for Physician Meetings
· MIPS
o Coordinates with AAN/FigMD/Verana Health/Greenway to track data required to report to CMS
o Coordinates with senior physicians to choose measures
o Communicates measures and required documentation needed to meet requirements of measures
o Evaluates best reporting options available for least cost
o Completes annual reporting and reports results to Executive Committee
5. Participate in professional development activities/education and maintain professional affiliations.
6. Serves as a member of the Senior Executive Team.
EDUCATION: Baccalaureate degree in business administration or related field.
EXPERIENCE: Minimum of five (5) years medical related business experience with two (2) years as a department manager in billing, accounting, or information systems.
KNOWLEDGE:
1. Knowledge of business management and basic accounting principles to direct the business office.
2. Knowledge of computer accounting programs, spreadsheets, and typical business related computer applications.
3. Knowledge of medical terminology, coding, and office procedures.
4. Knowledge of third party and insurance company procedures, regulations, and billing requirements and governmental reimbursement programs.
SKILLS:
1. Skill in establishing and maintaining effective working relationships with other employees, patients, organizations, physicians, and the public.
2. Skill in developing, implementing, and managing budgets.
3. Negotiation skills.
ABILITIES:
1. Ability to process patients and public inquiries and respond with poise and efficiency.
2. Ability to recognize, evaluate, problem solve, and correct errors.
3. Ability to conceptualize work flow, develop plans, and implement appropriate actions.
4. Ability to maintain confidentiality of sensitive information.
PHYSICAL/MENTAL DEMANDS:
Frequent mobility and/or sitting required for extended periods of time. Manual dexterity for using a calculator and computer keyboard. Some bending and stooping required.
ENVIRONMENTAL/WORKING CONDITIONS:
Work is performed in a busy office environment and requires both desk and counter work. Frequent contact with employees and outside agencies. Continual patient contact may involve dealing with angry or upset people.
This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, and working conditions may change as needs evolve.
