5 - 7 years
Posted 97 days ago
JOB TITLE: Manager, Revenue Management Practice Consultants
LOCATION: Buckhorn Office Building
WORK SCHEDULE: Days
WORK TYPE: Full Time
Provides management for Revenue Management Practice Consultant (RMPC) operational functions for the Geisinger Health System (includes Clinical Enterprise and all its affiliates). Implements and manages programs to ensure efficient billing related processes and workflows. Responsible for developing and providing system-wide and clinic specialty specific compliance and billing optimization education to Physicians and Clinical Operations.
RMPC responsibilities include identifying, analyzing, and implementing best practice work flows to maximize the collection of revenue and minimize the time and resources necessary to collect. RMPC works with department Clinical Directors, Division VPs, and Operations Directors/Managers to provide administrative leadership for the billing of clinical service(s). RMPC provides payment guideline analysis and business intelligence to facilitate maximization of clinical revenue. RMPC provides strategic direction to IT and System Support to maximize compliance and efficiency within the billing interfaces and extract processes.
Develops and provides system-wide provider education to support ICD-10 adoption and all coding changes. Works with the service line Clinical Champions and Epic Best Practice to develop and improve electronic medical record tools.
Manages the process to update CPT and ICD diagnosis codes in the billing systems as well as related charge assignment.
Manages processes related to the evaluation and analysis of government and third party payer guidelines and facilitates changes to allow billing processes and systems to remain in compliance.
Provides strategic direction to IT and System Support to maximize charge capture efficiency and minimize the time from date of service to date of payment.
COMPETENCIES AND SKILLS:
Demonstrates superior interpersonal, oral, written communication, and presentation skills.
Demonstrates ability to analyze and interpret detailed reports, develop clear conclusions, summarize findings.
Demonstrates ability to analyze and evaluate policies, methods and procedures, as well as clinic and billing work flows.
Demonstrates ability to lead projects and work groups and demonstrates strong collaborative skills and behaviors.
Demonstrates ability to lead and manage exempt highly-independent staff.
EDUCATION AND EXPERIENCE:
B.A. or B.S. in Finance, Accounting, Business Administration or related field required. M.B.A. or M.H.A. preferred.
Minimum of six years of experience within revenue management and/or hospital/clinic operations supporting regulatory requirements as they relate to revenue management required. Minimum of two years management experiencerequired.
In lieu of degree, existing staff in the Practice Consultant Senior roles may be considered with a minimum fourteen years of related experience and a minimum of two years management experiencerequired.
Outstanding knowledge of ICD-9, CPT-4, and HCPCS coding. AAPC CPC or AHIMA coding certification required. AHIMA approved ICD-10 Trainer is required.
Outstanding knowledge of federal regulations governing professional and hospital billing and reimbursement is required. Understanding of third party reimbursement policies is preferred.
Experience in providing financial analysis of healthcare operations required.
Billing, Collection and Reimbursement experience for both Professional and Hospital Services within an integrated delivery system with a centralized business office required.
WORKING CONDITIONS/PHYSICAL DEMANDS:
Work is typically performed in an office environment.