Job Description

Location: Sebastian River Medical Center
Posted Date: 8/2/2022

POSITION SUMMARY:

The Hospital CRO/CFO is both accountable and responsible for all aspects of the revenue cycle and the hospital financial management for the assigned hospital(s). The position reports to the Regional Chief Revenue Officer/ Chief Financial Officer with an additional reporting relationship to the assigned local Hospital(s) President.

KEY RESPONSIBILITIES:

The hospital CRO/CFO is accountable for ensuring all aspects of a fully optimized revenue cycle operation within the hospital setting including an advisory role to ensure financial statements are accurate and explained. The role is accountable for meeting Steward “Key Financial Metrics,” and working to appropriately address metric variances.

  • Accountable for overall revenue cycle, revenue integrity/quality, and ensuring all billing compliance and government regulations are followed.
  • Accountable for appropriate and accurate daily charge capture by department, daily department revenue reconciliations, fixing rejected charges, and minimizing late charges.
  • Accountable for oversight of denial management including edit worklists, root cause analysis, recommendations for process/system enhancements, and overall coaching and leading staff.
  • To advise and collaborate with centralized financial reporting to explain variances and determine mitigating actions.
  • The role oversees and is responsible for leading internal hospital departments and ensuring staffing levels are optimized across revenue cycle and may include Patient Access (Registration, Patient Financial Services, Referrals and Authorizations), Care Management (CM), Health Information Services (HIM) and Coding, Clinical Documentation Excellence (CDE), Revenue Integrity (RI) and Charging, Payer Auditing, Local Finance, and other areas as assigned.

Accountable for the following revenue cycle and financial components (subject to change by area):

  • Patient Access. Responsible for the following:
    • Patient Registration.
    • Insurance verification and approvals.
    • Ensuring appropriate Referrals.
    • Ensuring accurate Authorizations.
    • Copay collections.
    • Working related edits and denials.

  • Care Management. Responsible for the following:
    • Concurrent case management duties.
    • Discharge services.
    • Responsible for working with third party payers with respect to all level-of-care and length-of-stay issues.
    • Denial Management and follow up.
    • Working related edits and denials.

  • Health Information Management and Coding. Responsible for the following:
    • All medical records, transcription and coding.
    • Monitoring and enforcement of completion of records by physicians.
    • Monitoring and enforcement of coding by clinical departments.
    • Oversee coding operations.
    • Working related edits and denials.

  • Clinical Documentation Excellence. Responsible for the following:
    • Accuracy and thoroughness of all clinical documentation.
    • Appropriate diagnoses and CPT/HCPCS billing categories applied.
    • Education and training of clinical teams.
    • Working related edits and denials.

  • Revenue Cycle Operations/ Revenue Integrity and Charging. Responsible for the following:
    • Responsible for daily charge review for tracking hospital performance
    • Ensure daily charge reconciliation by department.
    • Escalation and issue management
    • Chargemaster coordination with central office
    • Late charge variances
    • Steward Financial Metrics
    • Working related edits and denials.

  • Payer Auditing. Responsible for the following:
    • Responsible for defending the hospitals’ interests on all third-party payer audits.
    • Tracking and reporting payer audit issues.
    • Working related edits and denials.

  • Financial Responsibilities. Responsible for the following:
    • Review annual net revenue budgets for hospital(s). Explain variances.
    • Review accuracy of financial statements and balance sheets.
    • Review and explain all deductions from revenue and bad debt.
    • Review integrity of net revenue monthly for all hospitals.
    • Adhoc financial analysis as required.

  • All other duties and responsibilities as assigned from time to time, including additional areas of oversight depending on hospital needs.

REQUIRED KNOWLEDGE & SKILLS:

  1. Extensive experience in revenue cycle operations and payer reimbursement knowledge.
  2. Requires analytic and technical skills, including a strong foundation of denial root cause analysis, escalating and presenting key revenue cycle issues, and proposing options to implement change.
  3. Financial statement and balance sheet knowledge.
  4. Organizational skills to manage multiple projects through effective planning and time management.
  5. Knowledge of Electronic Health Record and overall revenue cycle systems, Meditech experience helpful.
  6. Sound verbal and written communication skills; outstanding interpersonal skills; ability to relate positively with hospital operations and Executive Leadership Team.
  7. Leadership skills and ability to implement change and ensure standardization and consistency.
  8. Align with corporate policies and procedures.
  9. Compliance and government regulations including but not limited to HIPPA, EMTALA, CMS.
  10. Participates in projects and attends other team meetings as assigned.
  11. Creative, flexible, and self-motivated with sound judgment; ability to plan and implement.
  12. Commitment to service excellence.

EDUCATION/EXPERIENCE/LICENSURE/TECHNICAL/OTHER:

  1. Education: Bachelor's degree in relevant filed required, Master’s preferred.
  2. Experience (Type & Length): Minimum of ten years’ experience in healthcare, with significant experience in hospital revenue cycle functions.
  3. Hardware/Software: Meditech, MS Office (Excel, Word, PPT), Access, SQL, and/or other query/analytic tools.

Equal Employment Opportunity
Steward Health Care is committed to the principle of Equal Employment Opportunity for all employees and applicants. It is our policy to ensure that both current and prospective employees are afforded equal employment opportunity without consideration of race, religious creed, color, national origin, nationality, ancestry, age, sex, marital status, sexual orientation, or present or past disability (unless the nature and extent of the disability precludes performance of the essential functions of the job with or without a reasonable accommodation) in accordance with local, state and federal laws


Additional Information
Sebastian River Medical Center (SRMC), a Steward Family Hospital, nationally recognized facility located along Treasure Coast of Florida, offering high-quality care close to home. Housing over 178 beds, and fully accredited by the Joint Commission, Sebastian River boasts over 100 affiliated physicians, over 650 nursing and ancillary staff. When patients are in need of acute hospital care, Sebastian River provides state-of-the-art technology, as well as comprehensive emergency services and award-winning surgical care.

Sebastian River Medical Center is committed to achieving the highest level of measurable quality and efficiency in the delivery of health care services that are responsive to the needs and values of our patients, physicians, employees, and visitors. Sebastian River Medical Center recently underwent a facility expansion by adding another 46 patient rooms; 3 new Endoscopy Rooms and 6 new Operating Rooms with ability to expand up to 8 Operating Rooms to better serve our community.

Application Instructions

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