1. Lead team of Account Assistants and any associated Professional Revenue Cycle Specialists and Analysts organized by clinical department, practice and/or specialties that perform work such as professional coding, charge review and reconciliation. Establish priorities, assign projects and deadlines. Manage special projects for team as assigned. Cover vacancies when resources are unavailable. 2. Monitor productivity, timeliness, work completion and work quality of staff. Supervise, motivate and monitor accountability. Track and approve staff work hours. Identify training needs. Ensure cross-training to cover for staff absences. Participate in goal setting and regular discussions on progress toward goals for all staff. Evaluate performance and administer corrective discipline when applicable. Assist in evaluating staffing needs, development of position descriptions and performance criteria, recruitment and training. 3. Participate in development and implementation of effective operational workflows. Monitor Epic work queue aging and volume for timeliness of activity. Implement corrective actions to address delays or errors. Ensure that all functions and aspects of team operations are in compliance with established YMG policies and procedures, and University, governmental and third party contractual regulations, including claim submission, coding accuracy and documentation to support billing. Identify process improvements that will expedite collections, eliminate unnecessary work or duplication of efforts and/or reduce manual work and room for error. 4. In collaboration with YMG, the Epic Project Team and departmental staff and/or faculty, design systems to facilitate and maximize charge capture and accurate coding. Through extensive analysis of data, observations of clinical workflow and in consultation with faculty and staff, identify opportunities to optimize capture of all billable services. Provide advice on operational improvements to enhance efficiency of charge capture to reduce coding related denials and optimize overall reimbursement of clinical services. Develop, implement and manage processes to reconcile billed charges to scheduled visits, procedures or other sources of clinical charges. Establish consistent QA processes to identify opportunities for improvements in reducing manual work and risk of error. 5. Monitor daily, weekly, monthly Key Performance Indicators (KPI) on the Clinical Revenue Cycle to identify departmental trends that need review. Research outliers, identify root cause and provide feedback for continuous quality improvements. Identify areas of concern and assist with efforts to analyze data to determine resolution. Develop and implement corrective measures to address deficiencies. 6. In collaboration with the Practice Development and Training Specialists, assist with development of training programs and documentation of policies and procedures. In collaboration with other YMG staff, establish policies and procedures for revenue cycle work processes. 7. Function as a resource and educator for clinical department physicians and staff, Patient Financial Services insurance, cash, claims and customer service staff and the Epic Project team on charge capture, coding and government and commercial carrier payment policies. Assist with annual review of additions, deletions and changes to CPT, HCPCS, and ICD-CM codes and RVU values. 8. Regularly communicate with key clinical department, the Epic Project Team and YMG staff and managers. Plan, organize, facilitate and communicate results of regular meetings with staff and other YMG department or affiliate practice staff, physicians and/or administrators. 9. Lead and/or assist with Professional Revenue Cycle projects, such as analysis of charge review and claim edits. Participate on relevant committees. Work with other Professional Revenue Department staff on projects as assigned.
Required Skill/ability 5: Ability to work, plan, research and conduct projects with minimal supervision, and work effectively as a team member. Ability to lead team projects and develop cross-functional teams to achieve common goals. Demonstration of progressively responsible growth in the field.
Posting Position Title: Professional Coding & Charging Team Manager
Required Skill/ability 3: Extensive knowledge of CPT, ICD-10 and HCPCS codes and medical terminology. Excellent working knowledge of medical office/hospital systems, medical record management software (Epic preferred), encoders, Outlook e-mail and all Microsoft Office applications, along with business intelligence reporting tools.
Work Week: Standard (M-F equal number of hours per day)
University Job Title: Manager, Coding & Billing
Required Skill/ability 1: Demonstrated ability supervising employees and ability to coach and develop a large team to create a high performing organization. Excellent interpersonal and communication skills demonstrating a high degree of professionalism, diplomacy and accountability.
Required Skill/ability 4: Demonstrated technical knowledge of medical insurance billing procedures, third-party reimbursement methodologies and documentation/compliance requirements for providers. Working knowledge of government and commercial insurance rules and regulations pertaining to correct coding initiatives. Working knowledge of HIPAA regulations and impacts on operations.
Required Skill/ability 2: Ability to work in a stressful environment meeting timely deadlines and achieving goals. Ability to analyze and interpret detailed reports, develop clear conclusions and summarize findings. High level of integrity and innovative thinking, and actively contributes to the success of the organization.
Bachelor's degree in Business, Health Administration or related field and a minimum of four years related health sciences and/or clinical practice management work experience, or the equivalent combination of education and experience.
Internal Number: 50403BR
About Yale University
Yale University is an American private Ivy League research university located in New Haven, Connecticut. Founded in 1701 in the Colony of Connecticut, the university is the third-oldest institution of higher education in the United States.