About the Team:The Revenue Cycle team collaborates cross-functionally to ensure Fee For Service revenue is optimized. The team is comprised of trusted advisors who provide valued insights and deliver progressive solutions that drive Sound’s revenue goal across multiple service lines, providing an impact to the patient, our hospital partners and Sound Physicians.About the role:The Director of Dispute Resolution is responsible for the creation and management of efficient workflow processes and team to ensure appropriate payment of fee for service claims for all service lines. Primary area of resolution managed by this role includes out of network claims mediation and arbitration process and may also expand to denials for timely filing or provider enrollment effective dates as appropriate. This position will assist in developing analyses and processes to proactively support the business and optimize revenue cycle outcomes. This position will work closely with all Revenue Cycle and Managed Care to ensure alignment of priorities for in and out of network payers. This is a dynamic role that will interface with many departments across the organization as well as with our field operators and partners. Revenue Cycle is responsible for professional billing, vendor management, coding, quality assurance, and provider enrollment, among other activities.In this role, you will:Manage and oversee workflow processes according to state guidelines for appeal of out of network claims to include appeal, mediation and arbitration.Accurately gather, synthesize, analyze relevant information to support decision making and to develop process improvement strategies.Develop and track department standards of productivity metrics such as claims appealed, collection volume and rates and trends and make strategic recommendations to leadership team.Develop strategic plans for revenue cycle team based on analysis of outcomes of appeal process.Oversee vendor workflow processes to ensure timeliness and appropriateness of their work product and accuracy of data.Perform financial analysis based on appeals data to provide to stakeholders, including payer contracting department as basis for contracting metrics.Support annual budgeting, monthly financial and revenue forecastingSupport analysis of FFS (fee for service) collection trending on OON claims and strategyProvide assistance in creating models that connect strategies to measures of performancePrepare narratives, Power Point presentations, graphs and reporting for field operations, clients, and revenue cycle as needed.Develop and prepare ad-hoc reports related to the revenue cycleProactively inform leadership of trends and pending legislative changes that may impact the financial position or OON strategy for Sound.Lead and participate in Arbitration hearings with support from leadership and legal team as necessary or required.Other duties as assigned A successful candidate will have a demonstrated track record of a combination of these competencies, personal attributes, knowledge, and experience:Competencies:Visionary: The ability to create and communicate a compelling picture of the futureStrategic Thinking/Mindset: The ability to develop, execute, and rally your team around data-driven long-range plansRelationship Building and Maintenance: the ability to quickly create and nourish healthy, strong relationships among hospital partners, dyad/triad partners, and Sound team members at all levels (C-Suite, Sound, and Team)Thinks “systems”: Thinks beyond tasks to understand entire system required to achieve the best outcomes — people, processes, and technology; communicates with and incorporates all stakeholders into solutions. Strong data analytics and insight skillsDetail Oriented: Achieves thoroughness and accuracy when accomplishing a task, applying appropriate discernment on high priority issues.Change Capable: The ability to inspire others to navigate and progress through change by providing vision, the why, and feedback mechanisms.Communication: The ability to speak, write, and listen clearly and consistently.Personal Attributes:Innovative: Goes beyond the conventional with a willingness to try out different solutions. Questions the status quo as well as generating and implementing creative solutions to achieve business goalsIntegrity: Behaves in an honest, fair, and ethical manner. Shows consistency in words and actions. Models high standards of ethicsCredible: Able to quickly gain confidence and trust of individuals at all levels.Passionate: demonstrates drive for excellence in every aspect of the jobCuriosity: seeking to fully understand challenge in order to provide holistic strategic opportunity analysisKnowledge:Bachelor’s Degree in Health Administration, Business Administration, Information Systems or related field; or equivalent experience in lieu of degreeStrong background in federal and state laws and requirements relating to healthcare managementWorking knowledge of revenue cycle, healthcare payment models, physician practice management, payer contracting, and managed care modelsExperience:7+ years of revenue cycle experience, patient collections and continuous process improvement preferably in the healthcare industry serving in a leadership capacity.Strong quantitative skills preferred with proficiency in Excel and Power PointOther Details:Sitting at desk/working on computer up to eight hours a dayIndoor office environmentThis job description reflects the present requirements of the position. As duties and responsibilities change and develop, the job description will be reviewed and subject to amendment.