Empower Every New Yorker - Without Exception - to Live the Healthiest Life PossibleNYC Health + Hospitals is the largest public health care system in the United States. We provide essential outpatient, inpatient and home-based services to more than one million New Yorkers every year across the city's five boroughs. Our large health system consists of ambulatory centers, acute care centers, post-acute care/long-term care, rehabilitation programs, Home Care, and Correctional Health Services. Our diverse workforce is uniquely focused on empowering New Yorkers, without exception, to live the healthiest life possible.At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.
Job Description•Directs the maintenance of the CDM (Hospital and Physician Billing) by incorporating new charges/services identified by internal stakeholders, third-party resources, CMS special requirements, and coding updates.•Oversees the monitoring and change management practices for the CDM, revenue routing, and fee schedules, while maintaining consistency with third-party, regulatory oversight agencies and legislative requirements.•Ensures codes contained in the CDM and fee schedules are accurate and in compliance with regulatory and/or contractual guidelines and that claims logic is appropriate for accurate billing.•Analyzes CDM and makes recommendations for improvement or reimbursement maximization, including monitoring and intervention related to lesser of charge issues.•Implements the necessary activities and workflows that to minimizes compliance risk and ensure integrity in reimbursement by managing CDM health and standards.•Business owner for CDM (and related products) vendor activities, leading meetings and coordinating training with various H+H internal stakeholders to improve charge capture performance across the system. Evaluates vendor performance ensuring deliverables are met.•Directs system-wide initiatives to improve current charging, coding structures and processes in revenue generating departments to ensure appropriate capture and reporting of revenue and compliance with government and third-party payer requirements.•Collaborate with senior leadership to create and implement revenue enhancement initiatives aligned with organizational goals.•Coordinates with clinicians and HIM to propose innovative and necessary automations in EPIC to optimize charge capture and reduce denials while eliminating compliance risk.•Design and implement monitoring tools - dashboards and other reports that provide visual representation of data to support charge capture initiatives.•Prepare detailed reports and presentations on revenue performance metrics and project outcomes for executive leadership.•Manages system-wide workflows to identify, investigate, and capture SPARCS data per NYS guidelines and data requirements•Leads and participates in projects and other duties related to revenue cycle initiatives and duties.
Minimum Qualifications1. Master's degree from an accredited college or university in Accounting, Finance, Business Administration or a related discipline with an emphasis on accounting and financial systems; and four (4) years of responsible-level experience in fiscal management or administration with an emphasis on financial systems, management information and controls, three (3) years of which must have been in responsible administrative or managerial capacity; or2. Bachelor's degree from an accredited college or university in disciplines, as listed in 1 above; and five (5) years of experience, as described in 1 above, three (3) years of which must have been in a responsible administrative or managerial capacity.
Department PreferencesKnowledge, Skills, Abilities and other Requirements:•Microsoft Office Tools (Advanced Excel)•EPIC Resolute Billing•EPIC Reporting•NYSE-CONIf applying online, please include your cover letter in the same file attachment with your uploaded resume.NYC Health and Hospitals offers a competitive benefits package that includes:
- Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
- Retirement Savings and Pension Plans
- Loan Forgiveness Programs for eligible employees
- Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts
- College tuition discounts and professional development opportunities
- Multiple employee discounts programs