In February 2020, CDM went live, along with ColumbiaDoctors and New York Presbyterian Hospital, with the Epic shared electronic health record. In addition to being one of the first dental schools in the country to adopt an integrated medical-dental health record, the move to Epic has provided CDM with robust billing, charge review, and claim management functionality, along with powerful revenue cycle and financial management reporting tools. CDM's Revenue Cycle Director will be the person to leverage all of these investments and infrastructure and lead the revenue cycle operation to its next level of performance and be a source of transformation for the school.
Revenue Cycle Management
Central to the responsibilities of the Revenue Cycle Director is the effective and efficient management on a daily basis of the billing, cash collection, charge review and resolution, and claim management and resolution with payers in order to maximize revenue and cash flow. Through supervision of a team of analysts and collaboration with colleagues across the school and medical center revenue cycle departments, specific responsibilities include:
Oversight and management of charge review, claim edit and other billing and receivable work queues, tracking volume and aging of items and working with teams to resolve issues and maintain key performance metrics. Adjusting assignments and priorities as needed.
Most of the claim edit and management work is done through an outsource relationship, so the Revenue Cycle Director will meet regularly with this group to monitor performance, identify and resolve issues impacting performance, identify areas to improve efficiency.
Identify any functionality issues with the Epic electronic health record, interfacing systems, clearinghouse and remittance systems; conduct preliminary investigation to determine technical versus process and skill issues; follow up with central application support group to resolve technical issues; follow up with clinical leadership to resolve process and skill issues related to effective use of Epic.
Oversee fee schedules for both the teaching clinic and faculty practice, conducting analysis to ensure appropriate and reasonable pricing. Monitor payer contracts and pricing agreements to ensure accurate and current reimbursement rates. Be part of the leadership team who decides on changes to fee schedules and negotiations with payers.
Supervise the internal revenue cycle team at CDM, providing day-to-day supervision on work queue management, issue resolution, feedback to clinic providers and staff. Also responsible for the development of staff skill and experience across a range of clinical operations.
Meet regularly with providers and staff at the teaching clinic and faculty practice, bringing the insights from revenue cycle operations to improve effectiveness and efficiency to "upstream" revenue cycle operations such as registration, estimates, coding, cash collection, documentation and denial management. Also receives feedback from clinical providers and staff on areas of improvement in revenue cycle systems and operations.
Revenue Cycle Reporting
A key component to success in managing revenue cycle is the effective development and use of data and reporting to have true visibility into revenue activity, early and efficient insight into problems and performance challenges, robust models to effectively estimate financial performance and adjust as warranted. Reporting also provides essential feedback to individual providers on their performance and compensation, to staff on their financial management, and to practices, clinics and the school overall on its financial performance. Specific responsibilities include:
Reporting on all work queues with direction on necessary shift in attention, resources or escalation of underlying issues
Reporting on appointment volumes and revenues for all clinical operations, including trend and other key indicators
Individual monthly reporting for faculty providers working in the faculty practice and community practice on their productivity, charges, adjustments, collections and earnings. In addition to regular reporting, analytic reporting on optimization such as no-show rates, chair utilization rate, payer mix,
P&L reporting for the teaching clinic and faculty practices
Ad hoc reporting as requested by practice, clinic and school leadership
With a reporting line also to the Assistant Dean for Finance, the Revenue Cycle Director will be a member of the school's financial management team. Clinical revenue is a central component of the school's budget and also its most complex and variable one. The Revenue Cycle Director will work closely with the Assistant Dean, Vice Dean and medical center budget office to:
Develop and monitor the clinical revenue budget; provide detailed reporting and variance analysis; updating and implementing corrective action as warranted
Provide analysis and financial modeling for investments, business and strategic decisions contemplated and pursued by the school, providing a level of detail and insight to support effective decision making
Work with leadership to develop financial goals for clinic programs and practice locations with revenue targets
Develop, supervise and maintain daily cash processing workflows and associated reconciliations. Ensure all monies received to the general ledger match the posted receipts in Epic
Provide reporting and variance analysis for quarterly budget reporting and closes
Provide analysis, reporting and estimates through financial modeling for annual budget development and submission
Support annual financial audit and financial statement preparation for teaching clinic
Bachelor's degree required or equivalent in education and experience. Plus 5 years related experience.
Experience with Epic Professional Billing modules and reporting tools strongly preferred. Experience with business intelligence reporting tools strongly preferred. Experience with NYS Medicaid and Medicaid Managed Care preferred. Experience with dental coding, billing and insurance preferred but not required.
A minimum of 3 years of experience managing a revenue cycle operation in a hospital, outpatient or other institutional healthcare setting, with supervisory responsibilities. Demonstrated experience working with both governmental and private payers. Demonstrated experience managing enterprise-level systems for billing operations and reporting. Strong analytics skills and proficiency with Excel, including the use of pivot tables. Strong leadership and change management skills. Excellent interpersonal, supervision and communications skills. This is a demanding leadership role and, as such, requires stamina, resilience, tact and deep integrity.
Equal Opportunity Employer / Disability / Veteran
Columbia University is committed to the hiring of qualified local residents.
Internal Number: 514218
About Columbia University
Columbia University is one of the world's most important centers of research and at the same time a distinctive and distinguished learning environment for undergraduates and graduate students in many scholarly and professional fields. The University recognizes the importance of its location in New York City and seeks to link its research and teaching to the vast resources of a great metropolis. It seeks to attract a diverse and international faculty and student body, to support research and teaching on global issues, and to create academic relationships with many countries and regions. It expects all areas of the university to advance knowledge and learning at the highest level and to convey the products of its efforts to the world.