Director of Business Optimization

Position Summary

The Director of Business Optimization will work closely with the Department Administrator, CFO, and department coding and revenue teams to ensure that all patient billing activities are functioning optimally to maximize revenue, minimize errors and improve the overall patient experience.

Responsibilities

• Manage department staff responsible for processing charge review edits, ad hoc faculty practice reporting, good faith estimates, client accounts and provide enrollment tasks assigned to the department.
• Coordinate all new programs and procedures with FRO staff and Department Liaison so that staff is fully trained to collect revenue and address denials.
• Attend scheduled payer meetings on behalf of the department.
• In collaboration with the Department Administrator, provide ongoing monitoring and analysis of centralized revenue cycle functions, including assessment of CRO performance in the areas of write-offs/adjustments, denials, DAR, charge corrections, evaluation of high dollar charges and accounts, and submission of payer projects.
• Maintain and update department DRM documentation for CRO revenue cycle staff and provide training when needed.
• Closely monitor work queues to address issues that are preventing coding or claim submission resulting in revenue delays.
• Collaborate with CRO/Liaison to achieve ColumbiaDoctors revenue cycle targets and implement new Epic initiatives and upgrades
• Partner with contracting, compliance, and finance to interpret payer contracts and operationalize contract terms, including revenue of Anesthesia Addenda for current negotiations.
• Provide ongoing oversight and routine audit of Epic SER provider records to ensure accuracy, compliance, alignment with payer enrollment, and effective dates.
• Provide leadership on annual national published updates to CPT/ASA codes to ensure accurate Epic dictionary mapping of ASAs to CPTs required for coding and claim submission.
• Work as a subject matter expert to the department for all revenue cycle processes.
• Identify workflow issues within Epic PB Transaction Inquiry that are non-compliant with expected outcomes and can affect revenue collection.
• Conform to all applicable HIPAA, billing compliance, and other pertinent regulations.
• Perform general administrative functions, and related duties and responsibilities as assigned/requested.

Minimum Qualifications

• Bachelor’s degree or equivalent in education and experience, plus a minimum of five years of related experience.
• Thorough knowledge of project improvement management processes, the healthcare industry revenue cycle, reimbursement and payer contracting strategies and trends.
• Proficient in database, business intelligence and spreadsheet applications.
• Ability to communicate effectively in both oral and written form.
• Ability to work independently and collaboratively, with follow-through and to handle multiple tasks simultaneously.

Preferred Qualifications

• Master’s degree.
• Seven (7) years plus experience in health care and revenue cycle.
• Epic experience and prior supervisory experience.

Equal Opportunity Employer / Disability / Veteran

Columbia University is committed to the hiring of qualified local residents.