CO Sr Production Unit Manager

The Pathology Department is seeking a CO Sr. Production Unit Manager who will provide analysis, consultation, and reports to the Department Administrator and the Senior Director of Revenue Operations Physicians Billing Service (PBS). Reviews provider income data with department administration, Clinical Practice Association (CPA) and PBS management. Manages professional fee billing staff to ensure timely and consistent reimbursement for services. Interacts with physicians and their divisional managers to answer related questions and to clarify various billing concerns. Researches and resolves compliance issues. Maintain strict confidentiality of staff and patient information. Will promote teamwork and identify areas of improvement and recommend coordinated actions to bring about changes.

Specific Duties & Responsibilities

Procedural Knowledge

• Working knowledge of Assistant, Associate and PUM roles and responsibilities.
• Develop and monitor department group incentive plan targets. Analyze and present data for exceptions, if needed.
• Provide assistance to the Department Administrator and the Senior Director of Revenue Operations Physicians Billing Service (PBS) in the form of analysis, consultation, planning day-to-day management of the financial and administrative billing operation of the department.
• Manages professional fee billing staff to ensure timely and consistent reimbursement for services rendered by clinicians from patients, insurance carriers, and/or state and federal agencies as appropriate.
• Researches and resolves compliance issues and clarifies various billing concerns. Explains monthly service, income and rejection-analysis reports to department physicians, faculty, administration, Clinical Practice Association (CPA) and Physicians Billing Service (PBS) management.
• Interface with third-party professional relations representatives to include Commercial, HMO, Medicare, Blue Shield and Medicaid. Meets periodically with representatives to discuss payment problems, coding compliance issues, and claim receipts.
• Act as departmental liaison with payer to stay current with changes in insurance requirements for several hundred payers, assuring that office procedures meet specifications for prompt payment.
• Monitors charge and revenue budget variances and provides explanation to department Management.
• Direct the development of billing policies and procedures for the departments' professional fee billing offices consistent with, and complementary to, those already in place with the CPA.
• Perform yearly reviews of encounter forms.
• Broad scope of responsibility which includes interactions with physicians, administrators and divisional directors regarding divisional performance.
• Department has large number of subspecialties requiring expanded knowledge of billing requirements of 3rd party payers.
• Provide assistance to the Department Administrator and the Senior Director of Revenue Operations Physicians Billing Service (PBS) in the form of analysis, consultation, planning day-to-day management of the financial and administrative billing operation of the department.
  

• Manages professional fee billing staff through subordinate managers and supervisors to ensure timely and consistent reimbursement for services rendered by clinicians.
  

• Develops and presents divisional monthly report packages to directors and provides in-depth financial analysis at divisional level.
  

• Manage large production unit with multiple subspecialties requiring broader scope of specialty knowledge and associated budgets.
  

• Oversee and Analyze subspecialty data and routinely interacts with physician divisional directors to review subspecialty billing information used in development of future business strategies.
  

• Participate and chair various committees on both a departmental, as well as a school wide level.
  

• Monitors essential monthly reports to ensure productivity, unit, core services and CPA objectives are met for their areas of responsibility.

Technical Knowledge

• Comprehensive knowledge and compliance of HIPAA rules and regulations in the dissemination of patient Protected Health Information (PHI).
• Utilize online resources including IDX, Compass and Cognos to facilitate efficient claims processing.
• Requires a thorough understanding of medical billing and the unique customer service requirements as related to patients, physicians and administrative staff in a high-volume medical services environment.
• Excellent communication and customer service skills with the ability to work well under pressure.

Professional and Personal Development<