Pennsylvania Medicine

Mgr Revenue Cycle

Pennsylvania Medicine$80K — $110K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • High School Diploma/GED with 7+ years billing/revenue cycle experience or a Bachelor's Degree in Business, Accounting, or Healthcare with 3 years of management experience.
  • Familiarity with EHR programs and medical terminology, including ICD-10, CPT, and HCPCS coding processes.
  • Proficient in Microsoft PowerPoint and intermediate in Microsoft Excel and Word.
  • Strong understanding of healthcare reimbursement and denial management processes.
  • Excellent written and verbal communication skills.

Responsibilities

  • Oversees daily operations of the billing office and ensures accurate processing and resolution of charges and denials.
  • Analyzes financial and statistical data related to revenue cycle and creates distribution reports.
  • Monitors charge/revenue work queues and ensures timely resolution of accounts.
  • Leads projects aimed at revenue cycle and operational improvements.
  • Guides and manages departmental staff, including training and performance appraisals.
  • Develops relationships with clinical and revenue cycle stakeholders to enhance workflow.
  • Keeps abreast of industry standards and regulatory changes affecting revenue cycle.

Benefits

  • Comprehensive employee benefits and compensation package.
  • Prepaid tuition assistance program.
  • Employee engagement programs fostering dedication to the mission.
  • Opportunities for professional development and training.
Full Job Description
Position: Manager Revenue Cycle

Entity: Clinical Practices of University of Pennsylvania

Department: OB-GYN Admin

Location: 3400 Spruce St

Hours: Full Time

Summary:
  • The Revenue Cycle Manager oversees and manages the daily operations of the billing office to ensure all charges are processed, billed accurately, and any denials or edits are resolved and followed-up on in a timely manner. Reporting to the Director, Revenue Cycle, the role is responsible to work both internally within the department and externally with other members of the health system to support the goals and protocols of revenue cycle workflow and/or revenue affecting tasks. The individual must be able to process large quantities of data to monitor Key Performance Indicators (KPI) and research all barriers to successful revenue cycle management.
  • The Revenue Cycle Manager will perform analysis of financial and statistical data related to revenue cycle, including the creation, analysis, and distribution of revenue related reports. The individual provides leadership and training to analysts and specialists, coordinates the resolution of HB and PB related WQ issues, and identifies areas of improvement and education opportunities. Works with leadership to support issues related to Registration, Charge Capture, Billing, Charge Correction and Revenue Cycle Workflow Assessments.
  • Provides subject matter expertise to revenue cycle leaders and other key stakeholders, and other duties as assigned.

Responsibilities:
  • Establishes and monitors auditing and clinical billing office policies and procedures to ensure maximization of revenue for department.
  • Monitors all charge/revenue related work queues to ensure resolution of accounts are occurring in a timely manner and leads support for WQ analytics for technical and professional services.
  • Reports, investigates, and resolves significant revenue cycle metrics variances identified through continuous monitoring reports. Coordinates front, middle, and back-end analytics in regards to department revenue. Recommends thorough analysis, solutions of revenue cycle problems.
  • Project lead for revenue cycle/operational improvement projects and activities.
  • Manages staff; interviews, hires, and guides direct reports with staff training, distribution of work, holding accountable for performance measures, appraises performance with rewards and discipline including annual evaluations, addresses complaints and resolves issues that may arise, and acts as a mentor for all department staff.
  • Develops and maintains strong working relationships with Clinical Documentation staff (EM, Observation Medicine, Hyperbarics and Wound Center), Revenue Cycle Leaders, and other UPHS internal partnerships.
  • Stays current with industry standards, rules, and regulations affecting reimbursement and revenue cycle and assists to implement changes accordingly to maximize revenue for services rendered in compliance with established third-party guidelines.
  • Maintains confidentiality with respect to medical records and corporate documents (HIPAA, JCAHO, etc.).

Education or Equivalent Experience:
  • H.S. Diploma/GED AND 7+ years billing/revenue cycle experience (Required).
  • OR Bachelor's Degree in Business, Accounting or Healthcare AND 3 years supervisory or managerial experience and previous exposure to hospital or physician billing (Required).
Skills & Abilities:

  • Basic knowledge of EHR programs, Medical Terminology, ICD-10, CPT, HCPCS codes and coding processes (Required).
  • Basic skill level in Microsoft PowerPoint (Required).
  • Knowledge of clinical billing and collection (Required).
  • Thorough understanding of healthcare reimbursement and denial management processes (Required).
  • Strong written and verbal interpersonal skills (Required).
  • Leadership abilities along with communication, analytical, and organizational skills (Preferred)
  • Intermediate level skill in Microsoft Excel and Microsoft Word (Preferred).
  • Ability to develop and implement policies and procedures (Preferred).

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

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About Pennsylvania Medicine

The University of Pennsylvania is a private Ivy League research university in Philadelphia. It is the fourth-oldest institution of higher education in the United States and is ranked among the highest-regarded universities by numerous organizations and scholars. While the university dates its founding to 1740, it was created by Benjamin Franklin and leading Philadelphia citizens in 1749 . The University has four undergraduate schools as well as twelve graduate and professional schools. Schools enrolling undergraduates include the College of Arts and Sciences, the School of Engineering and Applied Science, the Wharton School, and the School of Nursing. Among its highly ranked graduate schools are its law school, whose first professor wrote the first draft of the United States Constitution, its medical school, the first in North America, and Wharton, the first collegiate business school. Penn's endowment is US$20.7 billion, putting it amongst the wealthiest academic institutions in the world, and its 2019 research budget was $1.02 billion. Penn was one of nine colonial colleges chartered before the U.S. Declaration of Independence when Benjamin Franklin, the university's founder and first president, advocated for an educational institution that trained leaders in academia, commerce, and public service. The campus, in the University City neighborhood of Philadelphia, is centered around College Hall, and notable landmarks are Houston Hall, the first modern "student union", and Franklin Field, the first double-decker college football stadium. Penn also is the home of the Morris Arboretum, the official arboretum of the Commonwealth of Pennsylvania, which is located 15 miles northwest of the campus, in the Chestnut Hill section of Philadelphia. The university's athletics program, the Quakers, fields varsity teams in 33 sports as a member of the NCAA Division I Ivy League conference.
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