Geisinger Health System Manager, Revenue Management Practice Consultants in BLOOMSBURG, Pennsylvania
JOB TITLE: Manager, Revenue Management Practice Consultants
LOCATION: Buckhorn Office Building
WORK SCHEDULE: Days
WORK TYPE: Full Time
Provides management for Revenue Management Practice Consultant (RMPC) operational functions for the Geisinger Health System (includes Clinical Enterprise and all its affiliates). Implements and manages programs to ensure efficient billing related processes and workflows. Responsible for developing and providing system-wide and clinic specialty specific compliance and billing optimization education to Physicians and Clinical Operations.
RMPC responsibilities include identifying, analyzing, and implementing best practice work flows to maximize the collection of revenue and minimize the time and resources necessary to collect. RMPC works with department Clinical Directors, Division VPs, and Operations Directors/Managers to provide administrative leadership for the billing of clinical service(s). RMPC provides payment guideline analysis and business intelligence to facilitate maximization of clinical revenue. RMPC provides strategic direction to IT and System Support to maximize compliance and efficiency within the billing interfaces and extract processes.
Develops and provides system-wide provider education to support ICD-10 adoption and all coding changes. Works with the service line Clinical Champions and Epic Best Practice to develop and improve electronic medical record tools.
Manages the process to update CPT and ICD diagnosis codes in the billing systems as well as related charge assignment.
Manages processes related to the evaluation and analysis of government and third party payer guidelines and facilitates changes to allow billing processes and systems to remain in compliance.
Provides strategic direction to IT and System Support to maximize charge capture efficiency and minimize the time from date of service to date of payment.
COMPETENCIES AND SKILLS:
Demonstrates superior interpersonal, oral, written communication, and presentation skills.
Demonstrates ability to analyze and interpret detailed reports, develop clear conclusions, summarize findings.
Demonstrates ability to analyze and evaluate policies, methods and procedures, as well as clinic and billing work flows.
Demonstrates ability to lead projects and work groups and demonstrates strong collaborative skills and behaviors.
Demonstrates ability to lead and manage exempt highly-independent staff.
EDUCATION AND EXPERIENCE:
B.A. or B.S. in Finance, Accounting, Business Administration or related field required. M.B.A. or M.H.A. preferred.
Minimum of six years of experience within revenue management and/or hospital/clinic operations supporting regulatory requirements as they relate to revenue management required. Minimum of two years management experience required.
In lieu of degree, existing staff in the Practice Consultant Senior roles may be considered with a minimum fourteen years of related experience and a minimum of two years management experience required.
Outstanding knowledge of ICD-9, CPT-4, and HCPCS coding. AAPC CPC or AHIMA coding certification required. AHIMA approved ICD-10 Trainer is required.
Outstanding knowledge of federal regulations governing professional and hospital billing and reimbursement is required. Understanding of third party reimbursement policies is preferred.
Experience in providing financial analysis of healthcare operations required.
Billing, Collection and Reimbursement experience for both Professional and Hospital Services within an integrated delivery system with a centralized business office required.
WORKING CONDITIONS/PHYSICAL DEMANDS:
Work is typically performed in an office environment.
The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria considered necessary to successfully perform the job.
OUR PURPOSE & VALUES:
Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION : We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
One of the nation’s most innovative health services organizations, Geisinger serves more than 1.5 million patients in Pennsylvania and New Jersey. The system includes 13 hospital campuses, a nearly 600,000-member health plan, two research centers and the Geisinger Commonwealth School of Medicine. Geisinger is known for its focus on caring and innovative programs including the ProvenCare® best-practice approach to maximize quality, safety and value; ProvenHealth Navigator® advanced medical home; Springboard Health® population health program to improve the health of an entire community; ProvenExperience™ to provide refunds to patients unhappy with their care experience; and Geisinger’s MyCode® Community Health Initiative, the largest healthcare system-based precision health project in the world. With more than 215,000 volunteer participants enrolled, MyCode is conducting extensive research and returning medically actionable results to participants. A physician-led organization, with approximately 32,000 employees and more than 1,800 employed physicians, Geisinger leverages an estimated $12.7 billion positive annual impact on the Pennsylvania and New Jersey economies. Repeatedly recognized nationally for integration, quality and service, Geisinger has a long-standing commitment to patient care, medical education, research and community service. For more information, visit geisinger.org or connect with us on Facebook, Instagram, LinkedIn and Twitter.
We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners.* Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality.
** Does not qualify for J-1 waiver. We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
*Domestic partner benefits not applicable at Geisinger Holy Spirit.