The Revenue Manager will oversee the revenue cycle activities associated with services of Transplant clinical enterprise, with the goal of maximizing reimbursement in a cost-effective manner that is in compliance with federal/state and payer-specific billing requirements. The knowledge, skills, and abilities we prefer are centered around cost-reporting, contract management and overall reimbursement experience.
Preference given to candidates with a Bachelor's degree.
The practice specialist will oversee the revenue cycle activities associated with services of assigned clinical area, with the goal of maximizing reimbursement in a cost-effective manner that is in compliance with federal/state and payer-specific billing requirements.
- Coordinate activities of staff responsible for charge capture, coding, charge entry, insurance follow up, reimbursement analysis, or other PRMO function for assigned clinical area
- Monitor performance for staff responsible for appointment scheduling, registration, clinic check-in, and clinic
of the revenue cycle for assigned clinical area.
- Develop and prepare/utilize reports to track financial and operational performance across the entire spectrum
management activities of the assigned clinical area.
- Review and recommend changes/updates to the departments charge master(s) to maintain fees at levels that maximize reimbursement.
- Review and recommend changes to department's charge capture documents to facilitate accurate and comprehensive billing in compliance with annual CPT-4 and ICD-9 updates.
- Identify revenue cycle problems, research/analyze data to resolve issues, identify and select alternatives to address outstanding issues, and implement solutions for improvement.
- Work with financial analyst, physicians, and administrative leadership to educate and train providers and staff about coding and other outstanding revenue cycle issues.
- Act as a liaison to managementand staff in the designated clinical area, PDC, PRMO, DUHS Hospitals, and third-party payers on revenue cycle activities for assigned areas.
- Continuously research, monitor, provide education and implement payer regulations and guidelines related to revenue
staff about coding and other outstanding revenue cycle issues.
- Coordinate revenue management orientation and educational activities of clinical personnel including providers and
Knowledge, Skills and Abilities
- Develop and utilize management models to monitor productivity and quality of staff performance.
- Develop and manage the budget for the staff and activities that are directly managed.
- Train, direct, and coordinate activities of assigned financial analyst /or other employees.
- Represent the PRMO in actively promoting the practice specialist concept throughout DUHS
At least 7 of the following: CPT/ICD/9 Coding, reimbursement systems including IDX, TES, Medicode,PAS, financial analytical skills, spreadsheet, database, APC, DRG, Third party reimbursement guidelines and procedures
Education 4 years college required in an accounting or business related field, Healthcare Policy or Administration, or Clinical Discipline
Experience 3 years required, 5+ years preferred relevant healthcare revenue, practice, or clinical experience
Degrees, Licensures, Certifications Degrees, Licensure, and/or Certification:BA, BBA, RN, CPC, RRA, or CPA, or higher
DUKE UNIVERSITY - 4 years ago
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