Manager PB Coding Denials Integrity - Medical Specialties

Manager PB Coding Denials Integrity - Medical Specialties/ Manager Med Revenue Cycle Major Responsibilities: Operational Leadership: Lead and manage daily operations within the assigned function area, ensuring alignment with divisional and enterprise-wide goals. Operational Efficiency: Evaluate processes to improve efficiency, enhance productivity, and support standardized best practices across the Mid-Revenue Cycle. Regulatory Compliance & Confidentiality: Ensure adherence to regulatory requirements, accreditation standards, and organizational policies. Maintain confidentiality of patient records and report any perceived non-compliant practices to leadership or the Compliance Department. Performance Monitoring & Reporting: Utilize key performance indicators (KPIs) to measure effectiveness, track trends, and implement data-driven strategies for improvement. Technology Utilization: Leverage healthcare technology and analytics tools to enhance efficiency, support decision-making, and drive innovation in Mid-Revenue Cycle processes. Collaboration & Stakeholder Engagement: Engage with clinical, IT, Compliance, and Revenue Cycle leaders to integrate Mid-Revenue Cycle processes effectively, ensure regulatory compliance, and promote patient safety. Build and maintain relationships with key stakeholders to drive communication, problem-solving, and operational alignment. Team Leadership & Development: Manage and develop a team of professionals by performing human resource functions such as hiring, performance evaluations, and professional development. Provide training, feedback, and career growth opportunities to foster a high-performing and financially responsible workforce. Strategic Initiatives & Execution: Lead initiatives to improve operational effectiveness, oversee timelines, and drive system enhancements. Licensure, Registration, and/or Certification Required: Relevant industry certification from an approved accrediting body. Education Required: Bachelor’s degree in health information management , Healthcare Administration, or a related field , or equivalent experience. Experience Required: ?? Minimum 8 years of experience in mid-revenue cycle operations, coding, HIM, or healthcare technology, including 2+ years of leadership experience in a large integrated healthcare system. Knowledge, Skills & Abilities Required: Mid-Revenue Cycle Expertise: Demonstrated knowledge of facility coding, professional coding, and HIM operational guidelines and workflows necessary to scope of work. Understanding of third-party reimbursement programs, state and federal regulatory requirements, national and local coverage decisions, and coding classification systems (ICD-10, CPT, HCPCS). Financial & Data Analysis: Ability to organize, compile and analyze data from various sources in order to detect patterns, and identify areas for improvement. Technology & Systems Proficiency: Strong understanding of EHR systems and other revenue cycle technology solutions. Proficient in Microsoft 365 products, including Teams, SharePoint, Word, Excel, PowerPoint, and Access. Process Improvement & Standardization: Experience in optimizing workflows and improving operational effectiveness within a complex healthcare environment. Skilled in prioritizing business needs and resource management to develop efficient and scalable processes. Leadership & Team Development: Proven ability to manage teams, coach staff, and foster a culture of continuous improvement and accountability. Ability to work effectively across multiple departments and within matrix organizational structures. Collaboration & Cross-Functional Communication: Strong interpersonal skills with the ability to engage clinicians, finance, IT, and revenue cycle teams to align goals, facilitate integration, and drive strategic initiatives. Problem-Solving & Attention to Detail: Ability to identify and solve problems creatively, work within deadlines, and maintain a high level of accuracy and attention to detail. Physical Requirements and Working Conditions: ????Exposed to normal office environment. Job may require travel, therefore, may be exposed to road and weather hazards. Must be able to lift up to 40 lbs. occasionally. Sits the majority of the workday, but also may lift, reach, and bend throughout the day. Operates all equipment necessary to perform the job. This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties. Advocate Health