About the position
Responsibilities
• Manage revenue cycle-related inquiries.
• Serve as Point Person/Service Line Resource (Liaison)
• Respond, research and resolve revenue cycle-related inquiries pertaining to assigned Maestro Care applications.
• Monitor and manage from key performance indicators.
• Independently complete data analysis.
• Monitor and manage reimbursement changes.
• Interpret and implement items communicated through payer policies.
• Provide training on charge capture, reconciliation, and correction as needed.
• Resolve accounts in assigned Charge Router, Charge Review. Claim Edit, and Follow-Up WQs.
• Utilize standard reports and/or develop new reports to track revenue cycle performance for assigned application clinical services.
• Review key metrics, from scheduling to billing & collections, in collaboration with PRMO Managers.
• Identify issues through ongoing monitoring of departmental metrics and/or through routine meetings with key operational managers within PRMO to facilitate communication.
• Continuously research and monitor payer regulations; provide education to operational areas.
• As applicable, coordinate with DHIP Revenue Managers to educate physicians to meet changing payer requirements/regulations.
• Facilitate revenue cycle collaboration and strategic planning activities.
• Serve as Duke Revenue Cycle Management and Integration lead for assigned areas to coordinate activities (reduce redundancies) and keep senior leadership informed.
• Coordinate and chair revenue-oriented workgroup activities and meetings.
• Manage communications among PRMO, hospitals, and physician practices.
• Arrange revenue cycle training activities.
• Participate in routine meetings with CFOs, AVP, Reimbursement Revenue Accounting to provide updates on current revenue cycle issues/priorities.
• Provide service line specific strategic planning/priorities to PRMO leadership through Revenue Manager Councils/Operations Meetings.
• Share operational changes to and from PRMO to hospital and physician practices.
• Develop or participate in focused workgroups to address topics such as registration, billing & collections, coding and charge capture, Maestro Care applications.
• Facilitate discussions and strategies to address operational issues.
• Managing communications between PRMO and Hospital Operational Owners and Providers.
• Organize and lead workgroups to routinely meet with Operations regarding PRMO function, issues, trends, etc., affecting revenue cycle performance.
• Actively participate in service line specific strategic planning around revenue cycle prioritization and planning.
• Maintain exceptional customer service, fortifying expectation of consistent professionalism and expertise.
• Must be capable of setting priorities and working under pressure.
• Coordinated activities are expected to be carried out with minor supervision.
• Escalate issues as needed.
• Manage and prioritize revenue and/or compliance requests.
• Manage projects simultaneously.
• Develop and manage action plans and maintain timelines.
• Organize and keep deadlines.
• Identify and recruit appropriate resources.
• Develop and maintain strong relationships.
• Develop creative solutions.
• Must be process oriented.
• Manage Annual CPT Updates: Coordinate, working with Health System Operations Managers in assigned applications: DUHS Revenue Management and PRMO
• Investigate and manage revenue opportunities identified through reporting and analysis.
• Specialize and manage revenue cycle functions and Epic Systems applications.
• Manage assigned Service Now tickets.
• Must be able to investigate charge and claim information and navigate information systems.
• Serve as EPIC System knowledge source for charge capture functions (charge capture, reconciliation, and corrections for procedures, medications, and supplies as appropriate) with specific applications.
Requirements
• Bachelor’s degree required.
• At least 6+ years of relevant Healthcare Care experience preferably in Charge Integrity is required.
• Strong leadership capabilities with demonstrated ability to lead, motivate, and collaborate effectively with Hospital leadership.
• Strong oral and written communication skills.
• The ability to work independently, proactively and adapt appropriately to changing priorities is a must.
• Must be able to communicate effectively, provide timely responses, identify resources to resolve inquiries.
• Must be able to facilitate meeting of multi- disciplinary teams.
• Must be capable of setting priorities and working under pressure.
• Must be process oriented.
• Must be able to investigate charge and claim information and navigate information systems.
Nice-to-haves
• Master’s degree preferred.
• Coding certification (e.g. CCS, CPC, RHIA, RHIT), HFMA CHFP (Certified Healthcare Professional), CRCR (Certified Revenue Cycle Representative) preferred.
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