A Brief Overview Under the supervision of the Director of Revenue Cycle this position oversees the functionality, workflow, and day-to-day activity for the billing, coding, and collections of the assigned CBO departments and practices and associated benchmarks and goals.
What You Will Do - Identifies problem areas and develops a plan of action to ensure benchmark standards are obtained and maintained.
- Researches coding questions/issues and presents solutions to management.
- Establishes service goals to be achieved and manages work quality; monitors compliance.
- Directly oversees staff members, and is responsible for ensuring their work output is satisfactory and their concerns are resolved. Is responsible for all hiring and related personnel decisions, completing routine performance review evaluations, leading employee engagement initiatives, training, scheduling, regular staff meetings, and the like.
- Meets regularly with Supervisors to ensure productivity and accuracy and to ensure consistency in quality and quantity while meeting departmental goals. Reports any discrepancies or issues to Director.
- Adjusts goals as needed to help increase staff performance and maintain quality.
- Encourages employee participation in process improvement by listing and giving feedback with respect to departmental needs.
- Monitors all billing and coding trends for issues. Works with internal departments and medical offices to offer solutions and assist in meeting revenue benchmarks.
- Assists in the development of new procedures that focus on improvement in quality and quantity of work performed.
- Maintains strict confidentiality in regard to patient's personal, medical and financial information.
- Acts as a role model for professionalism through appropriate conduct and demeanor at all times.
- Acts as a liaison between the Central Billing Office, physicians, and staff. Effectively communicates issues relative to claims processing difficulties and/or patient complaints.
- Offers and implements suggestions to increase work flow as appropriate.
- Manages operating expenses and FTE budget to meet department goals.
- Updates and creates new policies as needed in conjunction with Director.
- Maintains communication between Central Billing Office and Billing Services to resolve issues with provider numbers, system issues, and carrier issues.
- Performs additional duties as assigned.
Additional Responsibilities - Performs other duties as assigned.
- Complies with all policies and standards.
- For specific duties and responsibilities, refer to documentation provided by the department during orientation.
- Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.
Qualifications: Education - Associates Degree (Required)
- Bachelor's Degree (Preferred)
Work Experience - 5+ years Of progressive experience in healthcare revenue cycle operations (Required) and
- Supervisory experience, which includes experience hiring, training, evaluating, disciplining, developing, and engaging staff members. (Required) and
- Oracle, Kronos, Soarian, Athena, and/or claim scrubber experience (Preferred)
Knowledge, Skills, & Abilities - Must have an excellent working knowledge of claim submission (UB04/HCFA 1500) and third-party payers. (Required proficiency)
- Knowledge of Federal Billing Regulations (Required proficiency)
- Detail-oriented and organized, with good analytical and problem-solving ability. (Required proficiency)
- Notable client service, communication, presentation, and relationship-building skills (Required proficiency)
- Ability to function independently and as a team player in a fast-paced environment (Required proficiency)
- Must have strong written and verbal communication skills. (Required proficiency)
- High tolerance level for a potentially stressful environment. (Required proficiency)
- Excellent knowledge of ICD-10 and CPT coding as well as reimbursement. (Required proficiency)
- Demonstrated ability to use PCs, Microsoft Office suite, and general office equipment (i.e. printers, copy machine, FAX machine, etc.) (Required proficiency)
Licenses and Certifications - Certified Professional Coder (CPC) (Required) or
- Certified Coding Specialist (CCS) CCS-P (Required)