Practice Operations Director

Job Description

JOB TITLE: MSO Director

DEPARTMENT: Practice Solutions

REPORTS TO: Chief of Physician Operations

SCOPE OF JOB:

Responsible for oversight of Practice Solutions MSO. Coordinates front office functions with multiple clinics.  Coordinates performance improvement activities, ensures accreditation readiness of the billing office, front offices of multiple clinics, and establishes standard policies and procedures to ensure full and complete regulatory compliance.  Adheres to and supports business priorities and core values. 

QUALIFICATIONS:

Required: Must be a graduate of an approved College or University with a Bachelors Degree and a minimum of 5 years previous experience in the healthcare field and 5 years billing experience.  Certification in CPT coding preferred.   Basic knowledge of Medicare, BCBS, Medicaid and private insurance regarding benefits, coverage, and co-payment schedules/patient collection techniques.  Understanding of billing operating policies, ICD–9 and CPT codes; excellent organizational skills and data reporting.

Preferred: Excellent computer skills, word processing experience and software knowledge; ability to establish and maintain effective working relationships with patients, medical staff, and public.  

TYPICAL PHYSICAL/MENTAL DEMANDS:

Low to medium physical demand level capabilities required.  Cognitive skills necessary to perform essential job functions using independent judgment and decision making skills.  Strong oral and written communication skills.   Strong problem solving and reasoning skills.  Able to prioritize work for self and others, and organize time efficiently.  Must be able to work independently and with other professional staff and provide leadership in a team environment.   Must be able to handle stress and pressure, to make deadlines, and have ability to make decisions.  Be able to sit, walk, and stand for extended periods of time.

ESSENTIAL JOB FUNCTIONS: 

• Practice Startups:
• Assist in the development of new provider practices.
• Develop and maintain written billing office policies and procedures.
• Maintenance:
• Hires, terminates, consult, and conducts performance evaluations, and corrective action for non-clinical billing specialists and receptionists as required to ensure the effective functioning of the business office and the reception offices of each clinic.
• Assess staff education through hands-on coaching, teaching, mentoring, and/or through the provision of structured education or in-service programs.
• Schedules, supervises, and directs daily operations of physician practice billing and front office activities.
• Maintain appropriate practice management databases.
• Audits accounts, verifying compliance to generally accepted coding, billing and collections methodologies.
• Assists in the development, maintenance, and distribution of all required documents, productivity reports, and end-of-month data collection and reporting.
• Assist with the periodic and annual review and update of fee schedules (charge masters) and superbill formatting.
• Assist with the in servicing and training of physicians and communicate routinely with physicians regarding coding, billing and collections related problems and/or errors as well as general office tasks.
• Monitors cash collections and compliance with payment policies.
• Ensure that all physician practice activities meet federal compliance (OIG, HHS, Medicare/CMS, HIPAA) guidelines.
• Acts as a liaison with billing companies, health plans/payors, and collection agencies.
• Identify problems and communicate needs effectively.
• Demonstrates competence in relation to the defined mission, vision, values, and strategic plan of the organization.  This will be apparent by ongoing completion of any or all of the following: proficiency testing, skill demonstration, practice of core standards for service excellence, and documentation review.
• While performing job tasks, demonstrates awareness of age specific practices of the customer(s).
• While performing job tasks, demonstrates awareness of cultural and spiritual practices of the customer(s).
• While performing job tasks, demonstrates awareness of the functional status and physical needs of our customer(s).

MARGINAL JOB FUNCTIONS:

Performs other duties as assigned.