MGR, Rev. Cycle Mgmt, Provider

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Job Location (Full Address):

135 Corporate Woods, Ste 150, Rochester, New York, United States of America, 14623

Opening:

Worker Subtype:

Regular

Time Type:

Full time

Scheduled Weekly Hours:

40

Department:

920706 Dentistry Central Billing

Work Shift:

UR - Day (United States of America)

Range:

UR URG 112

Compensation Range:

$70,197.00 - $105,295.00

The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.

Responsibilities:

Manages the daily activities for the revenue cycle department. Provides revenue cycle related consultation for new services and expanded products, revenue optimization projects, and analyzing variances and understanding and reporting on key revenue cycle metrics. Assists in providing regulatory guidance as requested and implements any needed changes as required. Assists in overseeing many aspects of revenue cycle reporting. May be accountable for the budget, performance, and results of team of employees. Exercises full management authority, including performance reviews, pay decisions, recruitment, discipline, termination, and other personnel actions.

ESSENTIAL FUNCTIONS

• Directs and manages the Billing, Claims and A/R functions of the Revenue Cycle department of the Eastman Institute for Oral Health ?EIOH?, responsible for the billing, insurance claims and Accounts Receivable operations of the Institute, supervises the related department managers and staff and the third-party insurer relations function. Determines, develops, implements, and monitors policies and procedures to ensure complete and efficient charge entry, payment posting and accounts receivable management. Determines departmental review processes to ensure compliance and productivity of billing staff. Accountable for ensuring compliance with federal, state, and other regulations concerning Dental and Medical billing procedures and practices performed by the patient service providers of EIOH.

• Monitors and assesses current operations to identify opportunities for performance and process improvements and provides a high level of problem solving to support continual change management. Recommend improvements to the leadership team. Implements approved changes and oversees staff training to ensure an understanding of quality/performance improvement initiatives.

• Performs non-routine analyses on related issues and participates in various projects as directed by the Assistant Director of Revenue Cycle Management. Develops and maintains reports and communicates the results of billing operations to the Assistant Director of Revenue Cycle Management. Analyzes billing systems and procedures and recommends and implements changes for process improvements to maximize revenue. Manages non-routine claim and payment issues. Monitors accounts receivable and collection rates and take appropriate action to maximize reimbursement.

• Updates billing systems to ensure fee schedules are current and aligned with CDT/CPT/ICD10 codes. Reviews CMS, eMedNY and insurer regulations and policies to incorporate into dental and medical procedures and patient documentation as needed. Trains staff in proper billing and coding procedures and compliance issues related to third party billing. Is a key member of the leadership team working with third-party insurers to resolve payment issues.

• Supervises functional groups related to billing, claims and A/R including hiring, training, and performance evaluations. Provides leadership and training of staff in billing policies and third-party contracts. Ensure compliance with federal, state, and other regulations concerning billing policies and procedures. Assigns and monitors workflow to maximize efficiency. Provides opportunities for cross-training and development of staff skills.

• Monitors standard organizational metrics and utilizes data from all sources to create reports to meet the needs of all internal and external customers. Analyzes detailed operational and financial data to identify billing and claim related issues in regular reporting to leadership. Monitors effectiveness of resolution efforts and works with leadership team to develop and implement strategies to improve efficiency and decrease unbilled services across all payors.

• Keeps current on relevant areas of knowledge and acts as a resource to staff. Working in connection with the Compliance Department ensures compliance with regulatory standards and requirements. Keeps abreast of regulatory requirements, professional standards, and competitive industry practices, as well as organizational initiatives with potential to impact current operations. Monitors impact on existing activities to maintain service levels and work quality.

MINIMUM EDUCATION & EXPERIENCE

• 5 + years' experience in billing/coding and 3+ years in a management and supervisory position required minimum

KNOWLEDGE, SKILLS AND ABILITIES

• Working knowledge of CDT, CPT and ICD-10 guidelines and strong compliance background or national compliance certification required

LICENSES AND CERTIFICATIONS

• CPC or RHIT, CCS and nationally recognized billing certification (CMBS) preferred

The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University's Mission to Learn, Discover, Heal, Create - and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for all persons consistent with our values and based on applicable law.

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If you're looking for a career in higher education or health care, the University of Rochester may offer the perfect opportunity for your background and goals.

At the University of Rochester, we are committed to fostering, cultivating, and preserving an inclusive and welcoming culture and are united by a strong commitment to be ever better-Meliora. It is an ideal that informs our shared mission to ensure all members of our community feel safe, respected, included, and valued.