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Senior Manager, Revenue Cycle

Company: Oregon Health & Science University
Location: Portland
Posted on: January 27, 2023

Job Description:

Department Overview
This position is within the Women's & Children's Administrative Services team (WCAS) that serve the Departments of Pediatrics, Obstetrics & Gynecology, the Center for Women's Health, and the Institute on Development and Disability.
This position is the pivot point between charge creation and capture, coding and documentation compliance, referrals and authorizations. - The position's focus will be the development, maintenance and enhancement of processes that support full recovery of all professional fees while maintaining compliance with various institutional and industry regulations. - This position is also responsible for training faculty and staff on these processes and regulations and will provide leadership regarding key billing functions. - A key component of this position is the production of high-quality -data and reports on an ad hoc and routine basis.
Function/Duties of Position
1. Billing and Reimbursement

  • Designs and monitors tracking system and EPIC work queues to ensure all patient encounters generate a charge and that the charge is coded and documented appropriately. - Develops and implements policies and procedures that optimize and streamline revenue relevant functions. Monitors work queues and resolves problems or issues that may be responsible for transaction -backlog. - Manages the outpatient coding and documentation processes. - Works collaboratively with referral/authorization personnel and processes across the faculty practice sites to maximize the number of patient encounters that have proper referrals and authorizations. - Serves as a reference to PAS and billing staff. - Answers questions from all department personnel regarding authorizations, coding, documentation and self-pay policies. - Collaborates with departmental leadership to develop and communicate action plans for resolving billing issues.

    2. - Reporting/Analysis

    • Works closely with UMG and department leadership on the development of - -standard billing reports detailing departmental performance in relation to -clinical service standards, department set targets, and national benchmarks. -Compiles and formats various views of the billing and collection cycles to illustrate the performance of A/R drivers. - Reports clinic performance monthly -to physicians and Division administrators. - Provides ad hoc and routine reports as needed. -

      3. Compliance/Regulation

      • Coordinates training of faculty, residents and staff in appropriate protocols and documentation and coding of services that generate billing. - Works with Professional Services Coders on developing and implementing strategies to correct issues identified in internal audits. - Oversees fee schedule for professional fees, reviewing fees annually to ensure schedule remains competitive in the market. - Interfaces with OHSU compliance and integrity office. - Works with UMG to expand knowledge of reimbursement practices of insurers and to establish departmental processes to optimize patient care revenue. -

        4. Staff and Faculty Education

        • Collaborates with PAS personnel, residents and faculty to the basics of health insurance, purpose and technique of coding and documentation, managed care contracting and HCFA regulations and policies. - Maintains up-to-date knowledge on relevant industry changes and educates coders / providers on these changes. -

          5. -Human Resource Functions

          • Develops position descriptions, opens recruitments, and selects candidates. Responsible for supervision, including discipline and evaluation for billing team.

            6. - Supervisory -

            • This is a supervisory role.

              7. - Fiscal -

              • Monitors expenditures against departmental budget; prepares necessary documentation for supervisor review/approval; tabulates budgetary data, calculates figures, and checks for accuracy

                Required Qualifications

                • Bachelor's degree in relevant field or equivalent years of education, training, and experience.
                • 5 years of experience in medical billing, office or medical operations that included hands-on billing and collection and patient contact to include experience in physician practice management with responsibility for major components of billing management.
                • Knowledge of medical industry billing, coding, claims cycle, regulations, managed care, and authorization process.
                • Proficiency with spreadsheet and database applications.
                • Proven ability to effectively communicate concepts and instructions in written and verbal forms to all levels of staff in a service oriented manner.
                • Ability to compose policy and procedure documents.
                • Knowledge of the operations of a physician practice.
                • Strong analytical and organizational skills. -
                • Ability to manage large quantities of data and communicate effectively. -
                • Advanced knowledge of Excel.

                  Preferred Qualifications

                  • Demonstrated public speaking and training experience.
                  • Coding experience.
                  • Demonstrated knowledge of EPIC, Cognos.

                    Additional Details
                    Please upload a cover letter and resume.
                    All are welcomeOregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request reasonable accommodation contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or aaeo@ohsu.edu. As an organization devoted to the health and well-being of people in Oregon and beyond, OHSU requires its employees to be fully vaccinated against COVID-19.

Keywords: Oregon Health & Science University, Portland , Senior Manager, Revenue Cycle, Executive , Portland, Oregon

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