Senior Vice President, Revenue Cycle Management

Senior Vice President, Revenue Cycle Management

Job Overview:

The Senior Vice President will provide strategic planning, leadership, and direction for Revenue Cycle Management functions across the health system. Direct oversight of functions within the areas of Health Information Management and Centralized Business Office operations; coding, clinical documentation improvement, release of information, Data and Revenue Integrity, Optimization and Centralized Business Office operations. The Senior Vice President will ensure compliance with system objectives while enhancing the quality of services provides to ensure sustainability, growth, and process improvement surrounding Revenue Cycle Services.

Reports to:

• The Senior Vice President, Revenue Cycle Management reports directly to the Chief Revenue Cycle Officer of RWJBarnabas Health

Qualifications:

• Bachelor s Degree in Finance, Accounting or other related field
• Master s Degree preferred
• 10+ years of experience in revenue cycle management roles
• 5+ years of proven, progressive leadership experience
• Familiar with Medical Terminology
• Proficient with Epic - Electronic Health Record (EHR)
• Ability to manage multiple work streams, projects, tasks, and goals
• Knowledge and experience with industry charge methodology, billing, and collection regulations

Essential Functions:

Leadership and Revenue Cycle Management

• Promotes and supports a working environment consistent with the values-based culture of the organization.
• Provides direction and oversight of Revenue Cycle Operations, including but not limited to health information management, billing, claim follow-up and collections, payment application, and denials management.
• Builds and leads a high-performing revenue cycle team, including revenue cycle managers, billing specialists, coders, and other related staff.
• Fosters a culture of accountability, teamwork, and continuous improvement.
• Develop strategies across all functional departments to exceed cash collections, reduce days in AR, and reduce denial and adjustment rates.
• Partners with Hospital and Physician Operations and leadership around all aspects of the revenue cycle
• Tracks and monitors key revenue cycle performance indicators; reports key findings to appropriate leadership and stakeholders across the organization.
• Ensures systems and processes are in place to ensure compliance with contract requirements around submission of claims; including service provision/documentation, established fee schedules, and site enrollments.
• Partners with the Managed Care Team to manage payer contracts and support payer relationships.
• Provides oversight, in collaboration with financial leadership, on the general ledger close as it relates to revenue, accounts receivable and billing.
• Ensure internal controls, policies and procedures are consistent state and federal law, compliance plans and HIPAA.

RCM Technology/Electronic Health Record (EHR)

• Oversees the selection and implementation of revenue cycle management software and systems, leveraging technology and automation to improve workflow, accuracy, and efficiency.
• Provides and/or supports project management of EHR implementation and other Revenue Cycle Management Initiatives
• Ensures integrity of the EHR and related processes to minimize organizational risk
• Provides strategic recommendations around Revenue Cycle optimization and automation.

Mid-Cycle (Health Information Management Oversight)

• Provides strategic leadership and operational oversight for all Health Information Management (HIM) functions, including medical record integrity, coding, clinical documentation, and release of information.
• Oversees enterprise-wide coding operations, including DRG coding, procedural/surgical coding, anesthesia, ED, and inpatient professional coding, ensuring accuracy, compliance, and optimal reimbursement.
• Leads Clinical Documentation Improvement (CDI) efforts to enhance clinical accuracy and Risk Adjustment Factor (RAF) capture across the system.
• Develops and oversees strategies to accelerate adoption of automation, AI, and natural language processing (NLP) tools for coding, documentation, and transcription.
• Oversees vendor management for outsourced HIM services including coding and transcription, ensuring contract adherence, performance monitoring, and cost optimization.
• Directs the timely and compliant release of information (ROI), scanning, and transcription processes in accordance with HIPAA and regulatory standards.
• Leads payer audit response, clinical denial recovery, and utilization management integration efforts to support mid-cycle revenue integrity.
• Collaborates with IT and EHR teams to optimize Epic functionality and ensure integration of clinical alerts, documentation prompts, and coding tools at the point of service.
• Partners with compliance, quality, and clinical operations to align HIM practices with accreditation standards, audit preparedness, and performance improvement goals.
• Drives innovation and best practices in HIM and documentation practices, including strategies to minimize scanning and promote digital documentation at the point-of-care.

Corporate Accounts Receivable Management and Reporting

• Monitors and reports monthly to management; providing analysis of trends in aged balances across divisions, customers, and programs as well compared to trends in the industry.
• Monitors collections to established goals to maximize cash flow and to monitor claim submission to provide ongoing process assessment and resolution.
• Oversees the analysis and recording of revenue adjustments, write offs and denial activity; provides reporting on trends to management along with suggestions to mitigate future write offs and denied claims.
• Develops, implements, and oversees revenue cycle strategies and goals that align with the health system's financial objectives and long-term growth plans.
• Evaluates and enhances the efficiency of revenue cycle processes, including patient registration, charge capture, coding, billing, collections, and accounts receivable management.
• Ensures adherence to all relevant healthcare regulations, including HIPAA, CMS, and other federal and state guidelines.
• Stays up to date with regulatory changes and implement necessary updates to policies and procedures.
• Analyzes revenue cycle performance metrics, identify areas for improvement, and implements data-driven strategies to maximize revenue while minimizing denials and write-offs.
• Collaborates with other departments, including finance, clinical operations, and IT, to streamline processes, resolves issues, and drives cross-functional improvements.
• Develops and implements quality assurance programs to ensure accurate coding, billing, and claims processing, reducing errors and rejections.
• Promotes a positive patient financial experience through clear communication, financial counseling, and addressing patient concerns related to billing and payments.
• Prepares and presents regular financial reports to the executive leadership team, highlighting revenue cycle performance, trends, and opportunities for improvement.

Other Duties:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Benefits and Perks:

At RWJBarnabas Health, our market-competitive Total Rewards package provides comprehensive benefits and resources to support our employees physical, emotional, social, and financial health.

• Paid Time Off (PTO)
• Medical and Prescription Drug Insurance
• Dental and Vision Insurance
• Retirement Plans
• Short & Long Term Disability
• Life & Accidental Death Insurance
• Tuition Reimbursement
• Health Care/Dependent Care Flexible Spending Accounts
• Wellness Programs
• Voluntary Benefits (e.g., Pet Insurance)
• Discounts Through our Partners such as NJ Devils, NJ PAC, Verizon, and more!

Choosing RWJBarnabas Health!

RWJBarnabas Health is the premier health care destination providing patient-centered, high-quality academic medicine in a compassionate and equitable manner, while delivering a best-in-class work experience to every member of the team. We honor and appreciate the privilege of creating and sustaining healthier communities, one person and one community at a time. As the leading academic health system in New Jersey, we advance innovative strategies in high-quality patient care, education, and research to address both the clinical and social determinants of health.

RWJBarnabas Health aims to truly make a unique impact in local communities throughout New Jersey. From vastly improving the health of local residents to creating educational and career opportunities, this combination greatly benefits the state. We understand the growing and evolving needs of residents in New Jersey whether that be enhancing the coordination for treating complex health conditions or improving community health through local programs and education.

Equal Opportunity Employer