Golden Gate Urology, Inc. (GGU) is a unique, fast paced multi-specialty large medical group with multiple locations across the Bay Area. The largest free-standing Bay Area urology practice is strategically aligned with our radiation oncology center to deliver high-quality, patient-centric care to our community. GGU’s core values drive continual advancement and improvement in a dynamic and growth-focused environment.
As the Revenue Cycle Management (RCM) Operations Lead, you will be accountable for practice-wide financial and operational metrics with the goal of identifying and capitalizing upon opportunities for process/operational improvements and revenue optimization. The Operations Lead will effectively collaborate with financial and clinical stakeholders and serve as a liaison with internal and external entities in support of Revenue Cycle Analysis and Operations. The Operations Lead performs complex financial and operational analysis and serves as a subject matter expert with their in-depth understanding of revenue cycle infrastructure, metrics and reporting in order to support strategic initiatives and make recommendations to key stakeholders. This newly created full-time position with potential advancement opportunities reports to the Vice President of Finance and Administration in the Central Business Office (CBO).
Essential Duties and Responsibilities:
Oversee aspects of developing and implementing innovations to GGU’s RCM model including consistent strategies for performance improvement, vendor management, provider relations, patient satisfaction and compliance.
Collaborate with front-line staff, external billing and collections vendor and management to identify missed revenue opportunities and process excellence initiatives across the Revenue Cycle continuum and act as a catalyst for realizing these improvements.
Mitigate back-end revenue leakage through contract negotiation, change management, lean process improvement, rate reviews, billing audits, advanced quantitative analysis on core financial metrics and accountability for external billing and collections company performance.
Serves as a coach for training and subject matter expertise to ensure compliance, improve workflow, operational and financial performance, and provide value-add feedback to leadership. Develop training materials, process maps, and step by step instructions for GGU locations and vendors.
Maintain a high degree of adaptability, willing to regularly refocus effort setting an example for the organization of a data-drive approach to realize impact.
Develops, analyzes, and maintains timely reporting of meaningful Key Performance Indicators, financial and benchmarking data.
Analyze and document current standard practices and look for ways to create a more efficient and streamlined process to scale the business utilizing technology and help drive a culture of innovation across the organization. Acts as a catalyst for realizing these improvements.
Responsible for day-to-day operations of any centralized RCM offerings.
Maintain confidentiality of all Protected Healthcare Information as defined by HIPAA and ensures compliance across organization and external business associates.
Ensures compliance in federal, state and other regulations including corporate, compliance, licensure, safety and security as relates to general office operations
Coordinates and accountable for outsourced services including credentialing, billing and collections.
Develops industry knowledge and awareness of current market and regulatory issues that serves as a foundation for career progression.
Reads and abides by the company’s code of conduct, ethics statements, employee handbook(s), policies and procedures and other corporate mandates, including participation in mandatory training programs.
Responds to ad-hoc requests and develops solutions in a timely manner.
Other duties as assigned
3 - 5 years in medical practice billing, coding, collections and denials management with demonstrated progressive responsibility
Bachelor's Degree in Finance, Accounting or Business; OR equivalent experience/training
Practical and demonstrated experience in Provider relations, contracting and credentialing
Thorough knowledge of the practices, procedures, and concepts of the healthcare revenue cycle, specifically revenue integrity, and component operations, including billing, coding, collections, charge capture, contractual adjustments, third-party reimbursements, and compliance
Specialized knowledge in healthcare reimbursement revenue cycle workflow, financial reporting concepts, and industry best practices; proven ability to apply knowledge and skills to identify improvements.
Thorough knowledge of revenue cycle/business intelligence functions, analytics, industry standards, and best practices; advanced skills in reporting with various software tools specific to healthcare revenue cycle management
Thorough understanding of the issues, processes, reporting instruments, metrics, analytics, and other tools and techniques involved with measuring and analyzing the revenue cycle
Advanced analytical and problem-solving skills, with the ability to evaluate revenue cycle data to identify trends, report to leadership, and develop innovative solutions
Advanced interpersonal skills, with the ability to collaborate effectively on complex projects in a team environment
Advanced organizational and project management skills and the ability to lead a team, prioritize tasks, and see projects through from inception to completion on schedule
Practical experience using electronic health records and practice management systems, Epic billing system preferred, and strong Microsoft suite skills required including Excel and Powerpoint
Detail-oriented, with a proven ability to effectively manage time, see tasks and projects through to completion, organize competing priorities, and effectively address complex urgent issues as they arise
Strong critical thinking, analytical and problem-solving skills to manage complex information, assess problems, and development of effective solutions
Strong written and verbal communication skills, with the ability to interpret and convey complex clinical finance information in a clear, concise manner; ability to prepare compelling and informative reports and presentations to all levels of staff and management
Proven ability to help counterparts through difficult transitions to a new process, workflow, or situation.
Demonstrated passion for continual learning. Self-starter and regularly goes beyond what is asked to take on new challenges and create innovative solutions.
Proven ability to deep-dive into details and perform technical reviews and extensive process shadowing.
Proven ability to work in a matrix environment where multiple and competing customer demands are likely.
Coding certification preferred
Urology and/or Radiation Oncology experience a plus
High integrity, including maintenance of confidential information.
Based on business need, the ability to work a flexible schedule, including some evenings.
Golden Gate Urology, Inc. (GGU) is a unique, fast paced multi-specialty large medical group with multiple locations across the Bay Area. The largest free-standing Bay Area urology practice is strategically aligned with our radiation oncology center to deliver high-quality, patient-centric care to our community. GGU’s core values drive continual advancement and improvement in a dynamic and growth-focused environment.Equal Employment OpportunityGolden Gate Urology, Inc. is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.