Job Description
Description Reports to : VICE PRESIDENT OF REVENUE CYCLE MANAGEMENT
Supervises: SUPERVISORS, TEAM LEADS, AND STAFF
Responsible And Accountable For - Assists the VP of Revenue Cycle Management with oversight of the day-to-day functions of the Coding department staff
- Assists with escalated patient disputes
- Participates in a variety of tasks associated with problem solving and reasoning
- Makes every effort to remain flexible, cooperative, and a supportive member of the US Digestive Health team.
- Completes work efficiently and accurately
- Monitor and promptly address subordinate attendance concerns following company policies
- Complete 90-Day employee evaluations without being prompted
- Assure team members are following handbook policies and procedures; all exceptions require director approval
- Ensures timely charge entry for all services rendered in USDH facilities
- Works collaboratively with Vender Manager to ensure timely submission of all charges being billed via vender relationship
- Reports weekly / monthly on status of outstanding charges
- Tracks and monitors progress of ticket submission by providers and follows up as needed
- Provides education as needed to clinician and staff in the organization regarding billing and coding guidelines and policies
- Stays up to date on current and changing policies and regulations
- Works in collaboration with the compliance team on outside audits and ensures resolution of any outstanding items post audit
- Maintains QA on our internal coding team with results to be reported quarterly to VP, RCM
- Works closely with contracting team to ensure that fee and allowance schedules are maintained
- Assist in preparation of reports to share with payers when discrepancies in reimbursement are uncovered
- Review reimbursement and variance reports to identify and trend discrepancies in allowed amounts
- Provides consistent feedback and support to direct reports
- Collaborate with other members of the USDH RCM leadership team to improve processes, solve problems, and boost team morale
Typical Physical And Mental Demands - Full range of body motion; manual and finger dexterity and eye-hand coordination
- Bending, lifting, and carrying
- Extensive periods of sitting
- Normal color perception and corrected visual acuity and hearing to normal range
- Involvement with management, physicians, staff, and patients and their families
Typical Working Conditions - Clean environment in a gastroenterology physician’s office
- Potential exposure to communicable diseases
Duties And Tasks Include But Are Not Limited To - Keeps all patient information, practice information and staff information confidential
- Frequent mobility and/or sitting required for extended periods of time
- Some bending, lifting, and stooping required
- Normal color perceptions and corrected visual acuity
- Manuel dexterity to operate keyboard, calculator, and photocopier
- Involvement with management of information concerning physicians, mid-level practitioners, staff, hospital personnel, and patients
- Occasional high stress work may require dealing with angry, demanding patients and/or personnel
General - Follows established procedures, referring all new or unusual questions/concerns to Vice President, Revenue Cycle Management
- Acts as patient advocate, ensure a setting that protects the rights of the patient and well-being, safety, or dignity
- Demonstrates knowledge of OSHA, Code Blue, and Fire Safety measures
- Maintains knowledge of and complies with established policies and procedures
- Attends all required meetings
Specific - Creates a workplace culture that is consistent with the overall organization’s culture and emphasizes the identified mission, vision, guiding principles, and values of the organization. Leads employees to meet the organization’s expectations for productivity, quality, and goal accomplishment.
- Responsible for coding and approving payroll accurately in timekeeping system and tracking personnel attendance in accordance with current policy/practice.
- Hires appropriate staff within guidelines. Responsible for coordination of peer interviewing, and Customer Service within the department. Relies on Director for guidance.
- Establish and maintain relevant controls and feedback systems to monitor the operation of the departments.
- Review performance data that includes financial and activity reports and spreadsheets to monitor and measure departmental productivity, goal, achievement, and overall effectiveness.
- Prepare periodic reports for Senior Management as necessary or requested.
- Attends monthly manager meeting and/or other meetings as directed. Disseminates information from Director to department supervisors and staff. Schedules and leads monthly staff meeting. Maintains transparent communication. Appropriately communicates organization information through department meetings, one-on-one meetings, and appropriate electronic and interpersonal communication.
- Meets deadlines regarding required and ensures staff completes assigned training.
- Adheres to HIPAA Compliance. Maintains privacy of all parties regarding information as attained through written, verbal, or electronic disclosure. Maintains confidentiality of both patients and employees, consistent with facility guidelines. Reports privacy breaches to the correct personnel.
- Addresses facility and departmental communication through daily review of all correspondence, including incoming email messages.
- Lead and Coach department supervisors as needed, including goal setting for each department. Follows through to ensure that those goals are met.
- Provide support and feedback to leaderships teams on areas of improvement.
- Work in conjunction with the Director / VP on provider concerns and questions around wRVU’s, coding, and billing.
Requirements - Accredited high school diploma required
- CPC Required
- CPMA Preferred
- Working knowledge of ICD-10 and CPT Coding
- Knowledge of computer applications, computer generated reports, and electronic billing
- Extensive Excel experience preferred
- Must be able to work independently and efficiently with little supervision
- Must have a strong desire to teach / transfer knowledge to team members
- Ability to recognize, evaluate, solve problems, and correct errors including complex claims processing issues.
- Professional appearance, pleasant personality, and courteous manners with everyone while representing US Digestive Health
- Demonstrates a patient-focused attitude. Committed to providing excellent service to all patients, business partners, and visitors. Willingness to assist with genuine interest in the well-being of others.
- Must demonstrate ability to work in fast-paced, deadline-oriented environment where the ability to meet deadlines is a must with constant communication required.
- Demonstrates leadership and group cohesive skills that promote teamwork and group achievement.
- Effective written and verbal communication skills.
Job Tags
Casual work, Work at office, Flexible hours,