Revenue Cycle Mgr
Company: MedStar Health
Location: Columbia
Posted on: January 14, 2021
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Job Description:
Supports MMG Hospital Medicine in securing optimum reimbursement
for hospitalist services across the Baltimore and Washington DC
regions. Oversight of production and billing for professional
services. Recommends and implements front end changes and
enhancements in departmental processes to reduce receivables and
increase revenues. Oversees matters and projects related to billing
operations, reporting, audit, and quality
performance.Education/TrainingBachelor's Degree in Healthcare or
Finance, Master's Degree Preferred. Consideration given to
appropriate combination of education, training, and
experience.Experience5 years of progressively more responsible
job-related experience in healthcare operations and professional
billing preferred.License/Certification/RegistrationNo special
certification, registration or licensure required.Knowledge, Skills
& AbilitiesWorking knowledge of Physician Coding using CPT,
ICD-9/10, HCPCS and Modifiers. Excellent interpersonal skills,
especially written and oral communication skills. Proficiency with
Microsoft office application - particularly Excel and Access.
Report production and presentation skills. Detail oriented with
complex problem-solving skills. Ability to relate well to
physicians and other office administrators and staff, as well as
with back office billing management and staff. Must be able to
function in a team oriented, deadline and production driven work
environment. Ability to facilitate a focused team to defined
outcomes in a timely manner. Ability to comprehend and follow the
policies and procedures for MedStar Medical Group. Ability to
demonstrate ethical behavior that supports the organization's
mission, values, and commitment to compliance (including
maintaining patient confidentiality). Ability to work effectively
with people from a variety of culturally diverse backgrounds;
exhibits professionalism, courtesy and excellent customer
service.Primary Duties and Responsibilities1. Contributes to the
achievement of established department goals and objectives and
adheres to department policies, procedures, qualitystandards, and
safety standards. Complies with governmental and accreditation
regulations.2. Responsible for generating monthly/periodic reports
for Hospital Medicine. Researches, analyzes, documents, and reports
financial, practice andregulatory data and identifies and
communicates opportunities to maximize revenue.3. Assists with
designing, piloting, and executing effective and efficient
standardized billing processes across facilities. Serves as liaison
to codingvendors, IDX, PUBS, Patient Keeper, and other billing and
managed care teams.4. Assists with management of third-party coding
vendors.5. Works closely with billing stakeholders (PUBS, Charge
Entry, Compliance Office, and Customer Service) to provide
effective, efficient billingsolutions. Works to resolve missing
charges, research requests or questions concerning billing coding,
researches diagnosis codes for insurancepurposes in an effort to
provide appropriate information for financial resolution. Ensures
that requests for information from PUBS are completedefficiently
and accurately. Reconciles charges daily to ensure billing of
encounters. Monitor lag reports, pro-actively identify and address
issuescontributing to the lag, and problem solve as appropriate.6.
Manages new provider pre-bill hold audits and documentation and
coding review cycles. Facilitates ad hoc documentation audits.7.
Ensures accurate provider billing enrollment for all new and
existing providers. Responsible for facilitating review and
response of rejectionreports at all sites, ensuring rejections are
addressed and resolved, and final reports sent to Physician Unified
Billing Services (PUBS).8. Represents Hospital Medicine at monthly
IDX Users' Group meetings. Ensures that relevant information is
disseminated across department.9. Assists Administrative Directors
in preparing annual budgets for Hospital Medicine, including
forecasting and utilization.10. Develops and monitors provider
productivity and quality reports based on industry standards.11.
Maintains working knowledge of and compliance with relevant billing
process regulations from Medicare, Medicaid and any other Federal
or Stateprograms. This includes updating work processes, system
capabilities and policies and procedures as well as training staff
on changes.12. Participates in multidisciplinary quality and
service improvement teams as appropriate. Participates in meetings,
serves on committees andrepresents the department and
hospital/facility in community outreach efforts as appropriate.13.
Perform other duties as assigned.About MedStar HealthMedStar Health
is dedicated to providing the highest quality care for people in
Maryland and the Washington, D.C., region, while advancing the
practice of medicine through education, innovation and research.
Our 30,000 associates and 5,400 affiliated physicians work in a
variety of settings across our health system, including 10
hospitals and more than 300 community-based locations, the largest
visiting nurse association in the region, and highly respected
institutes dedicated to research and innovation. As the medical
education and clinical partner of Georgetown University for more
than 20 years, MedStar is dedicated not only to teaching the next
generation of doctors, but also to the continuing education and
professional development of our whole team. MedStar Health offers
diverse opportunities for career advancement and personal
fulfillment.
Keywords: MedStar Health, Baltimore , Revenue Cycle Mgr, Accounting, Auditing , Columbia, Maryland
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