Revenue Cycle Mgr

Company: MedStar Health
Location: Columbia
Posted on: January 14, 2021

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