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16775 Addison Road • Suite 315 • Addison, Texas 75001 • 214.377.1763
POSITION SPECIFICATION
__________________________________________________________________________________________
DIRECTOR OF REVENUE CYCLE – HOSPITAL BILLING
NW Metropolitan Atlanta in Marietta, Georgia
Position Specification – WellStar: Director, Revenue Cycle – Hospital Billing
16775 Addison Road • Suite 315 • Addison, Texas 75001 • 214.377.1763
2
Overview On behalf of our client, WellStar, Anthony Andrew is identifying and
evaluating candidates for the position Director of Revenue Cycle - Hospital Billing. This
person will lead the back-end billing processes of the revenue cycle.
This position is based in the northwest area of Atlanta in Marietta, Georgia.
WellStar Health System is a Marietta, Ga.-based not-for-profit healthcare system. We are a
nationally recognized leader in comprehensive care. Our specialists and primary care providers
work in a multi-disciplinary environment with more than 13,000 team members in our five
hospitals, 150+ WellStar Medical Group offices, health parks and other facilities.
Serving a population of more than 1.4 million residents throughout northwest metropolitan
Atlanta, WellStar constantly looks at total patient wellness and works to ensure that all systems
support that focus. As our numerous clinical and workplace accolades show, WellStar is
committed to caring for our patients, as well as our team members, like no other health system in
Georgia.
Staying ahead of the technology curve has enabled WellStar to be leaders in both the diagnosis
and treatment of an extensive array of health conditions. WellStar’s senior leadership, Board of
Trustees, hospital authorities, regional health and Foundation boards regularly evaluate our
community’s emerging needs to help equip our facilities with the best new technology.
In 2012, WellStar leadership took an epic step toward improving integration and communication
throughout every corner of our System. Powered by Epic software, WellStar Connect, our
electronic health record system, unites WellStar’s entire network of healthcare providers and
facilities with a single medical record across the care continuum.
Our System’s journey to world-class took another important step in 2014 when WellStar joined
the Mayo Clinic Care Network. WellStar’s participation in the Network further enriches the level
of care we provide through collaboration and innovation.
As a not-for-profit health system, it is our responsibility to give back to our communities. We do
this by not only providing quality care to our patients, but also through the support of the
WellStar Foundation. Of the tax-deductible contributions made to the Foundation, 100 percent is
reinvested into services and programs for the less fortunate in our communities as well as
enhancing our facilities here at WellStar.
Position Specification – WellStar: Director, Revenue Cycle – Hospital Billing
16775 Addison Road • Suite 315 • Addison, Texas 75001 • 214.377.1763
3
WellStar’s Vision: To deliver world-class healthcare.
WellStar’s Mission: To create and deliver high quality hospital, physician and other
healthcare related services that improve the health and well-being of the individuals and ----
communities we serve.
Recent System Accreditations, Awards and Recognitions
 Accredited Joint Commission on Accreditation of Healthcare Organizations
 Top 100 Most Highly Rated Integrated Healthcare Networks by IMS (5th overall)
 Top 10 company for working moms by Working Mother Magazine
 Fortune 100 Best Companies to Work For
 Top 10 Nonprofit Company for Executive Women (NAFE)
 Alfred P. Sloan award for Business Excellence in Workplace Flexibility
 Named among Best Employers for Workers over 50 by AARP
 Outstanding Achievement Award from Commission on Cancer of the American College
of Surgeons (WellStar Cancer Network)
 “3 Star” quality rating from the Society of Thoracic Surgeons
 Regional leadership award for 39-week elective delivery initiative
Leadership Team for Revenue Cycle
Jim Budzinski, VP and CFO, WellStar Health System
Sean Turner, VP Revenue Cycle
Additional information regarding WellStar is available at:
http://www.wellstar.org
Position Specification – WellStar: Director, Revenue Cycle – Hospital Billing
16775 Addison Road • Suite 315 • Addison, Texas 75001 • 214.377.1763
4
Position Description The Director of Revenue Cycle – Hospital Billing position
represents a significantly rewarding opportunity to join a financially strong and fast growing
system recognized as a national leader in comprehensive care.
Principal Accountabilities
 Provide operational direction and leadership for the hospital billing area of the Revenue
Cycle.
 Develop, mentor and manage the performance of a high performing team of 28 staff.
 Maintain a current working knowledge of and compliance with relevant billing process
regulations from Medicare, Medicaid, Champus/Tricare and any other Federal or State
program. This includes updating work processes, system capabilities and policies and
procedures as well as training staff on these changes.
 Maintain a current working knowledge of all related HIPPA regulations and ensures staff
compliance to these requirements. This includes updating work processes, system
capabilities and policies and procedures as well as training staff on these requirements.
 Maintain a strong knowledge of insurance billing and reimbursement procedures and
regulations related to insurance billing and collections.
 Develop and monitor quality and productivity metrics and benchmarks for the hospital
revenue cycle billing and reimbursement functions based on industry standards.
 Establish a continuous improvement work environment. Identify opportunities for
system and process improvements and drive change through targeted initiatives.
 Assist in the development, implementation and monitoring of the Billing departmental
budget, including forecasting utilization, determining cost and justifying staff
requirements.
 Conduct financial analysis of KPIs including payer denials, A/R trends, “Unbilled
Accounts” still in an unbilled status to ensure timely processing.
 Establish and maintain a culture that is patient- and internal customer-centric, grounded
in service excellence.
Position Specification – WellStar: Director, Revenue Cycle – Hospital Billing
16775 Addison Road • Suite 315 • Addison, Texas 75001 • 214.377.1763
5
Experience and Qualifications
 4+ years of progressive leadership including director level responsibility in a complex
healthcare organization.
 4+ years of experience managing hospital billing operations.
 A proven track record in the management of government and non-government billing.
Strong knowledge of federal and state regulations related to billing processes and
procedures.
 Experience with multiple/inter-facility billing operations through a centralized CBO,
LTAC billing, Medicare Part B through Benefits Exhausted.
 Thorough understanding of healthcare revenue cycle functions, operations and collection
control points, insurance claims processing and third party reimbursement.
 Knowledge of hospital patient accounting systems, electronic claims processing and
editing systems and detailed understanding of all negotiated agreements.
 Strong background in financial process management, performance improvement and
project/change management methodologies and practices.
 Comfortable interacting with all levels of staff including senior management.
 Self-directed with a collaborative style and a demonstrated ability to lead in a constantly
evolving environment driven by patient requirements and changing volumes.
 Excellent planning and organizational skills including the ability to translate strategic
vision/objectives into an operational model.
 Detail oriented; able to meet strict schedules and deadlines.
 Advanced proficiency in MS Office Word, Excel and PowerPoint.
 Bachelor’s degree in business, accounting, finance or healthcare is required.
 Strongly preferred experience in the following: EPIC and McKesson STAR, consulting,
Lean Six Sigma Green Belt certification.
Position Specification – WellStar: Director, Revenue Cycle – Hospital Billing
16775 Addison Road • Suite 315 • Addison, Texas 75001 • 214.377.1763
6
Key Competencies
An individual should demonstrate the following competencies to perform successfully the
essential functions of this position:
Change Leadership. Actively intervenes to create & energize positive change. Leads by
example.
Performance Management. Fosters high level of accountability through fair, hard
hitting performance management system. Free with deserved praise & recognition.
Constructive in criticism. Provides frequent feedback.
Training/Development/Coaching. Actively & successfully trains people. Coaches &
develops for promotion into positions where they succeed. People builder.
Communications – Oral & Written. Communicates well one on one, in small groups
and public speaking. Fluent, quick on feet, command of language. Keeps people informed.
Writes clear, precise, well-organized documents using appropriate vocabulary, grammar and
word usage.
Analytical Thinking. Makes a systematic comparison of two or more alternatives; notices
discrepancies and inconsistencies in available information; identifies a set of features,
parameters, or considerations to take into account, in analyzing a situation or making a
decision.
Initiative. Identifies what needs to be done and takes action before being asked or the
situation requires it. Notices and seizes opportunities to improve the status quo and explore
new areas of improvement.
Organization/Planning. Plans, organizes, schedules in efficient, organized manner.
Focuses on key priorities.
Likability. Puts people at ease. Shows Emotional Intelligence. Warm, sensitive,
compassionate. Not arrogant. Friendly, sense of humor, genuine.
Position Specification – WellStar: Director, Revenue Cycle – Hospital Billing
16775 Addison Road • Suite 315 • Addison, Texas 75001 • 214.377.1763
7
Success in the First Year
First 90 Days
 Meet one-on-one and invest time with Hospital and Professional Revenue Cycle leaders;
get to know them, their functional areas and what they are working on.
 Quickly acquire a solid base knowledge regarding the business of WellStar, what they
do, how they do it, their value proposition, etc.
 Learn key projects currently in process and those in the queue.
 Build rapport and support with other Shared Business Center Key Directors to ensure
cohesive Operations.
 Prepare monthly, meaningful reporting regarding the state of operational affairs.
 Complete performance assessment of direct reports and identify any gaps, training needs.
 Assess current departmental performance through reviewing process metrics, workflows
and denial root cause analysis.
 Develop expanded metrics for productivity review with staff. Begin to develop staff
understanding of these metrics, how they impact the metrics and how they relate to the
business.
 Monitor and refine current training program (WebEx and onsite) to close performance
gaps.
 Employ a collaborative style that is acknowledged by peers and senior leaders.
 Perform GAP analysis of current Billing Policies and Procedure to ensure currency of the
policies and appropriateness of regulatory compliance.
At 180 Days
 Determine and make changes to any process that is not driving the expected outcome
metric. Ensure communication and successful execution across the operations units
including the provider sites.
Position Specification – WellStar: Director, Revenue Cycle – Hospital Billing
16775 Addison Road • Suite 315 • Addison, Texas 75001 • 214.377.1763
8
 Build a seamless bridge between the Account Follow-up Division and Billing to ensure
that the interests of the organization are aligned jointly.
 Complete finalization plans for legacy system A/R and related financial impact scenarios.
By the End of the First Year
 Is a fully integrated and contributing member of the Revenue Cycle leadership team that
everyone trusts and respects, seeks advice from and provides thought leadership from a
process perspective.
 Appropriate process metrics have been determined and implemented for both charge and
claim edits.
 Established process metrics are in the optimal range and driving positive business
outcome metrics.
 Is the System Subject Matter Expert for Billing related questions and operational
guidance.
 Peers and senior leaders acknowledge the value the Director has brought to the
organization.
Reporting Relationship
The Director of Revenue Cycle – Hospital Billing reports to the AVP – Revenue Cycle.
Compensation
The company provides an attractive compensation plan consisting of a market-competitive
base salary and annual incentive program. A package will be constructed to attract the best
candidates.
Travel
Up to 10% travel is required.
Position Specification – WellStar: Director, Revenue Cycle – Hospital Billing
16775 Addison Road • Suite 315 • Addison, Texas 75001 • 214.377.1763
9
Community Information T
Atlanta/Marietta, Georgia
The city of Marietta, Ga., is a full-service municipality distinguished by its unique history,
sense of community and modern quality of life.
The city's economic development, police, fire, parks and recreation, public works,
environmental services, power and water departments serve citizens and businesses.
Marietta is 15 miles northwest of Atlanta and the Cobb County seat. At 23 square miles,
Marietta is one of Georgia's most populous cities, with 56,579 residents calling the city
home.
The National Civic League judged Marietta one of the 10 best communities in the nation as a
2006 All-America City, the oldest and most-respected community recognition award in the
country. CNNMoney.com named Marietta one of the top 25 places in the United States to
retire in 2011.
For a virtual tour of the city’s historic sites and points of interest, visit the link below.
http://www.mariettaga.gov/city/visitors/virtualtours
Position Specification – WellStar: Director, Revenue Cycle – Hospital Billing
16775 Addison Road • Suite 315 • Addison, Texas 75001 • 214.377.1763
10
Anthony Andrew Anthony Andrew is a personalized retained search firm created for
clients and candidates who want the highest standards of values, performance and results.
We believe our clients and candidates deserve nothing less. Major areas of retained search
include senior leaders and individual performers of all functional areas in the Healthcare,
Hospital Revenue Cycle, Information Technology, and Outsourcing Industries.
We look forward to working with you as a potential candidate for the Director of Revenue
Cycle - Hospital Billing position for WellStar, in Atlanta/Marietta, Georgia. For additional
information on Anthony Andrew, please visit our Website at anthonyandrew.com. To learn
more about this particular position or provide a confidential referral, please contact:
Tony Cinello
Founder and President
16775 Addison Road
Suite 315
Addison, Texas 75001
214-377-1763
tony@anthonyandrew.com
Improving Companies and Careers, One Search at a Time. SM

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Position specification director revenue cycle hospital billing-well_star_012915

  • 1. 16775 Addison Road • Suite 315 • Addison, Texas 75001 • 214.377.1763 POSITION SPECIFICATION __________________________________________________________________________________________ DIRECTOR OF REVENUE CYCLE – HOSPITAL BILLING NW Metropolitan Atlanta in Marietta, Georgia
  • 2. Position Specification – WellStar: Director, Revenue Cycle – Hospital Billing 16775 Addison Road • Suite 315 • Addison, Texas 75001 • 214.377.1763 2 Overview On behalf of our client, WellStar, Anthony Andrew is identifying and evaluating candidates for the position Director of Revenue Cycle - Hospital Billing. This person will lead the back-end billing processes of the revenue cycle. This position is based in the northwest area of Atlanta in Marietta, Georgia. WellStar Health System is a Marietta, Ga.-based not-for-profit healthcare system. We are a nationally recognized leader in comprehensive care. Our specialists and primary care providers work in a multi-disciplinary environment with more than 13,000 team members in our five hospitals, 150+ WellStar Medical Group offices, health parks and other facilities. Serving a population of more than 1.4 million residents throughout northwest metropolitan Atlanta, WellStar constantly looks at total patient wellness and works to ensure that all systems support that focus. As our numerous clinical and workplace accolades show, WellStar is committed to caring for our patients, as well as our team members, like no other health system in Georgia. Staying ahead of the technology curve has enabled WellStar to be leaders in both the diagnosis and treatment of an extensive array of health conditions. WellStar’s senior leadership, Board of Trustees, hospital authorities, regional health and Foundation boards regularly evaluate our community’s emerging needs to help equip our facilities with the best new technology. In 2012, WellStar leadership took an epic step toward improving integration and communication throughout every corner of our System. Powered by Epic software, WellStar Connect, our electronic health record system, unites WellStar’s entire network of healthcare providers and facilities with a single medical record across the care continuum. Our System’s journey to world-class took another important step in 2014 when WellStar joined the Mayo Clinic Care Network. WellStar’s participation in the Network further enriches the level of care we provide through collaboration and innovation. As a not-for-profit health system, it is our responsibility to give back to our communities. We do this by not only providing quality care to our patients, but also through the support of the WellStar Foundation. Of the tax-deductible contributions made to the Foundation, 100 percent is reinvested into services and programs for the less fortunate in our communities as well as enhancing our facilities here at WellStar.
  • 3. Position Specification – WellStar: Director, Revenue Cycle – Hospital Billing 16775 Addison Road • Suite 315 • Addison, Texas 75001 • 214.377.1763 3 WellStar’s Vision: To deliver world-class healthcare. WellStar’s Mission: To create and deliver high quality hospital, physician and other healthcare related services that improve the health and well-being of the individuals and ---- communities we serve. Recent System Accreditations, Awards and Recognitions  Accredited Joint Commission on Accreditation of Healthcare Organizations  Top 100 Most Highly Rated Integrated Healthcare Networks by IMS (5th overall)  Top 10 company for working moms by Working Mother Magazine  Fortune 100 Best Companies to Work For  Top 10 Nonprofit Company for Executive Women (NAFE)  Alfred P. Sloan award for Business Excellence in Workplace Flexibility  Named among Best Employers for Workers over 50 by AARP  Outstanding Achievement Award from Commission on Cancer of the American College of Surgeons (WellStar Cancer Network)  “3 Star” quality rating from the Society of Thoracic Surgeons  Regional leadership award for 39-week elective delivery initiative Leadership Team for Revenue Cycle Jim Budzinski, VP and CFO, WellStar Health System Sean Turner, VP Revenue Cycle Additional information regarding WellStar is available at: http://www.wellstar.org
  • 4. Position Specification – WellStar: Director, Revenue Cycle – Hospital Billing 16775 Addison Road • Suite 315 • Addison, Texas 75001 • 214.377.1763 4 Position Description The Director of Revenue Cycle – Hospital Billing position represents a significantly rewarding opportunity to join a financially strong and fast growing system recognized as a national leader in comprehensive care. Principal Accountabilities  Provide operational direction and leadership for the hospital billing area of the Revenue Cycle.  Develop, mentor and manage the performance of a high performing team of 28 staff.  Maintain a current working knowledge of and compliance with relevant billing process regulations from Medicare, Medicaid, Champus/Tricare and any other Federal or State program. This includes updating work processes, system capabilities and policies and procedures as well as training staff on these changes.  Maintain a current working knowledge of all related HIPPA regulations and ensures staff compliance to these requirements. This includes updating work processes, system capabilities and policies and procedures as well as training staff on these requirements.  Maintain a strong knowledge of insurance billing and reimbursement procedures and regulations related to insurance billing and collections.  Develop and monitor quality and productivity metrics and benchmarks for the hospital revenue cycle billing and reimbursement functions based on industry standards.  Establish a continuous improvement work environment. Identify opportunities for system and process improvements and drive change through targeted initiatives.  Assist in the development, implementation and monitoring of the Billing departmental budget, including forecasting utilization, determining cost and justifying staff requirements.  Conduct financial analysis of KPIs including payer denials, A/R trends, “Unbilled Accounts” still in an unbilled status to ensure timely processing.  Establish and maintain a culture that is patient- and internal customer-centric, grounded in service excellence.
  • 5. Position Specification – WellStar: Director, Revenue Cycle – Hospital Billing 16775 Addison Road • Suite 315 • Addison, Texas 75001 • 214.377.1763 5 Experience and Qualifications  4+ years of progressive leadership including director level responsibility in a complex healthcare organization.  4+ years of experience managing hospital billing operations.  A proven track record in the management of government and non-government billing. Strong knowledge of federal and state regulations related to billing processes and procedures.  Experience with multiple/inter-facility billing operations through a centralized CBO, LTAC billing, Medicare Part B through Benefits Exhausted.  Thorough understanding of healthcare revenue cycle functions, operations and collection control points, insurance claims processing and third party reimbursement.  Knowledge of hospital patient accounting systems, electronic claims processing and editing systems and detailed understanding of all negotiated agreements.  Strong background in financial process management, performance improvement and project/change management methodologies and practices.  Comfortable interacting with all levels of staff including senior management.  Self-directed with a collaborative style and a demonstrated ability to lead in a constantly evolving environment driven by patient requirements and changing volumes.  Excellent planning and organizational skills including the ability to translate strategic vision/objectives into an operational model.  Detail oriented; able to meet strict schedules and deadlines.  Advanced proficiency in MS Office Word, Excel and PowerPoint.  Bachelor’s degree in business, accounting, finance or healthcare is required.  Strongly preferred experience in the following: EPIC and McKesson STAR, consulting, Lean Six Sigma Green Belt certification.
  • 6. Position Specification – WellStar: Director, Revenue Cycle – Hospital Billing 16775 Addison Road • Suite 315 • Addison, Texas 75001 • 214.377.1763 6 Key Competencies An individual should demonstrate the following competencies to perform successfully the essential functions of this position: Change Leadership. Actively intervenes to create & energize positive change. Leads by example. Performance Management. Fosters high level of accountability through fair, hard hitting performance management system. Free with deserved praise & recognition. Constructive in criticism. Provides frequent feedback. Training/Development/Coaching. Actively & successfully trains people. Coaches & develops for promotion into positions where they succeed. People builder. Communications – Oral & Written. Communicates well one on one, in small groups and public speaking. Fluent, quick on feet, command of language. Keeps people informed. Writes clear, precise, well-organized documents using appropriate vocabulary, grammar and word usage. Analytical Thinking. Makes a systematic comparison of two or more alternatives; notices discrepancies and inconsistencies in available information; identifies a set of features, parameters, or considerations to take into account, in analyzing a situation or making a decision. Initiative. Identifies what needs to be done and takes action before being asked or the situation requires it. Notices and seizes opportunities to improve the status quo and explore new areas of improvement. Organization/Planning. Plans, organizes, schedules in efficient, organized manner. Focuses on key priorities. Likability. Puts people at ease. Shows Emotional Intelligence. Warm, sensitive, compassionate. Not arrogant. Friendly, sense of humor, genuine.
  • 7. Position Specification – WellStar: Director, Revenue Cycle – Hospital Billing 16775 Addison Road • Suite 315 • Addison, Texas 75001 • 214.377.1763 7 Success in the First Year First 90 Days  Meet one-on-one and invest time with Hospital and Professional Revenue Cycle leaders; get to know them, their functional areas and what they are working on.  Quickly acquire a solid base knowledge regarding the business of WellStar, what they do, how they do it, their value proposition, etc.  Learn key projects currently in process and those in the queue.  Build rapport and support with other Shared Business Center Key Directors to ensure cohesive Operations.  Prepare monthly, meaningful reporting regarding the state of operational affairs.  Complete performance assessment of direct reports and identify any gaps, training needs.  Assess current departmental performance through reviewing process metrics, workflows and denial root cause analysis.  Develop expanded metrics for productivity review with staff. Begin to develop staff understanding of these metrics, how they impact the metrics and how they relate to the business.  Monitor and refine current training program (WebEx and onsite) to close performance gaps.  Employ a collaborative style that is acknowledged by peers and senior leaders.  Perform GAP analysis of current Billing Policies and Procedure to ensure currency of the policies and appropriateness of regulatory compliance. At 180 Days  Determine and make changes to any process that is not driving the expected outcome metric. Ensure communication and successful execution across the operations units including the provider sites.
  • 8. Position Specification – WellStar: Director, Revenue Cycle – Hospital Billing 16775 Addison Road • Suite 315 • Addison, Texas 75001 • 214.377.1763 8  Build a seamless bridge between the Account Follow-up Division and Billing to ensure that the interests of the organization are aligned jointly.  Complete finalization plans for legacy system A/R and related financial impact scenarios. By the End of the First Year  Is a fully integrated and contributing member of the Revenue Cycle leadership team that everyone trusts and respects, seeks advice from and provides thought leadership from a process perspective.  Appropriate process metrics have been determined and implemented for both charge and claim edits.  Established process metrics are in the optimal range and driving positive business outcome metrics.  Is the System Subject Matter Expert for Billing related questions and operational guidance.  Peers and senior leaders acknowledge the value the Director has brought to the organization. Reporting Relationship The Director of Revenue Cycle – Hospital Billing reports to the AVP – Revenue Cycle. Compensation The company provides an attractive compensation plan consisting of a market-competitive base salary and annual incentive program. A package will be constructed to attract the best candidates. Travel Up to 10% travel is required.
  • 9. Position Specification – WellStar: Director, Revenue Cycle – Hospital Billing 16775 Addison Road • Suite 315 • Addison, Texas 75001 • 214.377.1763 9 Community Information T Atlanta/Marietta, Georgia The city of Marietta, Ga., is a full-service municipality distinguished by its unique history, sense of community and modern quality of life. The city's economic development, police, fire, parks and recreation, public works, environmental services, power and water departments serve citizens and businesses. Marietta is 15 miles northwest of Atlanta and the Cobb County seat. At 23 square miles, Marietta is one of Georgia's most populous cities, with 56,579 residents calling the city home. The National Civic League judged Marietta one of the 10 best communities in the nation as a 2006 All-America City, the oldest and most-respected community recognition award in the country. CNNMoney.com named Marietta one of the top 25 places in the United States to retire in 2011. For a virtual tour of the city’s historic sites and points of interest, visit the link below. http://www.mariettaga.gov/city/visitors/virtualtours
  • 10. Position Specification – WellStar: Director, Revenue Cycle – Hospital Billing 16775 Addison Road • Suite 315 • Addison, Texas 75001 • 214.377.1763 10 Anthony Andrew Anthony Andrew is a personalized retained search firm created for clients and candidates who want the highest standards of values, performance and results. We believe our clients and candidates deserve nothing less. Major areas of retained search include senior leaders and individual performers of all functional areas in the Healthcare, Hospital Revenue Cycle, Information Technology, and Outsourcing Industries. We look forward to working with you as a potential candidate for the Director of Revenue Cycle - Hospital Billing position for WellStar, in Atlanta/Marietta, Georgia. For additional information on Anthony Andrew, please visit our Website at anthonyandrew.com. To learn more about this particular position or provide a confidential referral, please contact: Tony Cinello Founder and President 16775 Addison Road Suite 315 Addison, Texas 75001 214-377-1763 tony@anthonyandrew.com Improving Companies and Careers, One Search at a Time. SM